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Elective neck treatment in clinically node-negative paranasal sinus carcinomas: impact on treatment outcome

 Won Hee Lee  ;  Seo Hee Choi  ;  Se-Heon Kim  ;  Eun Chang Choi  ;  Chang Geol Lee  ;  Ki Chang Keum 
 RADIATION ONCOLOGY JOURNAL, Vol.36(4) : 304-316, 2018 
Journal Title
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Elective neck dissection ; Elective neck irradiation ; Locoregional recurrence ; Maxillary sinus carcinoma ; Overall survival ; Paranasal sinus carcinoma
PURPOSE: The indication of elective neck treatment (ENT) for clinically N0 (cN0) paranasal sinus (PNS) carcinoma remains unclear. We aimed to investigate different treatment outcomes regarding ENT and propose optimal recommendations for ENT. MATERIALS AND METHODS: We identified patients with cN0 PNS carcinoma who underwent curative-intent treatment between 1992 and 2015. Survival outcomes and pattern of failure were compared between patients who received ENT and those who did not. We sought to identify significant patient or pathologic factors regarding treatment outcomes. RESULTS: Among 124 patients meeting the inclusion criteria, 40 (32%) received ENT ('ENT (+) group') and 84 (68%) did not ('ENT (-) group'). With a median follow-up of 54 months, the 5-year overall survival (OS) was 67%, and the 5-year progression-free survival (PFS) was 45%. There was no significant difference between the ENT (+) and ENT (-) groups regarding OS (p = 0.67) and PFS (p = 0.50). Neither group showed a significantly different pattern of failure, including regional failure (p = 0.91). There was no specific benefit, even in the subgroups analysis by tumor site, histologic type, and T stage. Nevertheless, patients who ever had regional and/ or distant failure showed significantly worse prognosis. CONCLUSION: ENT did not significantly affect the survival outcome or pattern of failure in patients with cN0 PNS carcinomas, showing that ENT should not be generalized in this group. However, further discussion on the optimal strategy for ENT should continue because of the non-negligible regional failure rates and significantly worse prognosis after regional failure events.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Se Heon(김세헌)
Lee, Won Hee(이원희) ORCID logo https://orcid.org/0000-0002-0950-1851
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Choi, Seo Hee(최서희) ORCID logo https://orcid.org/0000-0002-4083-6414
Choi, Eun Chang(최은창)
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