Management of the N0 neck--reference or preference.

For patients with squamous cell carcinoma of the upper aerodigestive tract, appropriate management of the regional lymph nodes is an important and often controversial issue that has significant influence on survival. Over the years radical treatment either by surgery or radiotherapy contributed to improvement in prognosis. Recently, a more conservative approach has achieved a similar level of cancer control with less morbidity. This review considers the issues of selection of patients for treatment of the neck, choice of modality and extent of therapy, treatment of the contralateral neck, management of recurrence and influence of the site and status of the primary lesion.

[1]  J. Jacobs,et al.  Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. , 2004, The New England journal of medicine.

[2]  S. Lam,et al.  Contralateral neck recurrence of squamous cell carcinoma of oral cavity and oropharynx. , 2004, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[3]  P. Rubin,et al.  Second malignancies in patients who have head and neck cancer: incidence, effect on survival and implications based on the RTOG experience. , 1989, International journal of radiation oncology, biology, physics.

[4]  R H Hruban,et al.  Molecular assessment of histopathological staging in squamous-cell carcinoma of the head and neck. , 1995, The New England journal of medicine.

[5]  W. Wei,et al.  A comparison of the prognostic significance of tumor diameter, length, width, thickness, area, volume, and clinicopathological features of oral tongue carcinoma. , 2000, American journal of surgery.

[6]  K. Pitman,et al.  Sentinel Lymph Node Biopsy in Head and Neck Squamous Cell Carcinoma , 2002, The Laryngoscope.

[7]  L. Kowalski,et al.  Prognostic significance of the distribution of neck node metastasis from oral carcinoma , 2000, Head & neck.

[8]  K. Lam,et al.  Occult lymph node metastasis in small oral tongue cancers , 1992, Head & neck.

[9]  K. Maclennan,et al.  Prognostic significance of microscopic and macroscopic extracapsular spread from metastatic tumor in the cervical lymph nodes. , 2002, Oral oncology.

[10]  E. Applebaum,et al.  Radiotherapy or surgery for subclinical cervical node metastases. , 1989, Archives of otolaryngology--head & neck surgery.

[11]  G. Fletcher,et al.  Elective irradiation of the neck lymphatics for squamous cell carcinomas of the nasopharynx and oropharynx. , 1971, The American journal of roentgenology, radium therapy, and nuclear medicine.

[12]  H. Fukuda,et al.  European Organization for Research and Treatment of Cancer (EORTC) and International Society for Cutaneous Lymphoma (ISCL) consensus recommendations for the management of cutaneous B-cell lymphomas Blood 2008; 112(5):1600-9 , 2022 .

[13]  R. Brentani,et al.  End results of a prospective trial on elective lateral neck dissection vs type III modified radical neck dissection in the management of supraglottic and transglottic carcinomas , 1999, Head & neck.

[14]  M. Alloisio,et al.  Prognostic significance of lymphatic spread in head and neck carcinomas: therapeutic implications. , 1985, Head & neck surgery.

[15]  W. Mendenhall,et al.  Elective neck irradiation for squamous cell carcinoma of the head and neck: analysis of time-dose factors and causes of failure. , 1986, International journal of radiation oncology, biology, physics.

[16]  H. Hamakawa,et al.  Lymph node micrometastases in head and neck cancer: a review. , 2001, Acta oto-laryngologica.

[17]  A. Yuen,et al.  Salvage of recurrent head and neck squamous cell carcinoma after primary curative surgery , 2003, Head & neck.

[18]  O. Hoekstra,et al.  Positron emission tomography using [18F]fluorodeoxyglucose (FDG-PET) in the clinically negative neck: is it likely to be superior? , 2004, European Archives of Oto-Rhino-Laryngology and Head & Neck.

[19]  J. Shah,et al.  Epidermoid carcinoma of the supraglottic larynx. Role of neck dissection in initial surgical treatment. , 1974, American Journal of Surgery.

[20]  Y. F. Poon,et al.  Treatment of stage I nasopharyngeal carcinoma: analysis of the patterns of relapse and the results of withholding elective neck irradiation. , 1989, International journal of radiation oncology, biology, physics.

[21]  J. Shah,et al.  Changing concepts in the surgical management of the cervical node metastasis. , 2003, Oral oncology.

[22]  J. Gaa,et al.  Positron emission tomography in combination with sentinel node biopsy reduces the rate of elective neck dissections in the treatment of oral and oropharyngeal cancer. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[23]  H. Pillsbury,et al.  A Rationale for Therapy of the N0 Neck , 1997, The Laryngoscope.

[24]  E. Myers,et al.  Neck dissection: an operation in evolution: Hayes Martin lecture. , 2003, Archives of otolaryngology--head & neck surgery.

[25]  K. Devaney,et al.  Immunohistochemical Studies in the Identification of Lymph Node Micrometastases in Patients with Squamous Cell Carcinoma of the Head and Neck , 2004, ORL.

[26]  D. Soutar,et al.  Improved Staging of Cervical Metastases in Clinically Node-Negative Patients With Head and Neck Squamous Cell Carcinoma , 2004, Annals of Surgical Oncology.

[27]  S. Stoeckli,et al.  Is there a role for positron emission tomography with 18F‐fluorodeoxyglucose in the initial staging of nodal negative oral and oropharyngeal squamous cell carcinoma , 2002, Head & neck.

[28]  R. Cantrell,et al.  The influence of extent of neck treatment upon control of cervical lymphadenopathy in cancers of the oral tongue. , 1991, International journal of radiation oncology, biology, physics.

[29]  R. Weber,et al.  Frequency and therapeutic implications of “skip metastases” in the neck from squamous carcinoma of the oral tongue , 1997, Head & neck.

[30]  M. Robiony,et al.  Is Extended Selective Supraomohyoid Neck Dissection Indicated for Treatment of Oral Cancer with Clinically Negative Neck? , 2000, Acta oto-laryngologica.

[31]  C. R. Leemans,et al.  Assessment and Clinical Significance of Micrometastases in Lymph Nodes of Head and Neck Cancer Patients Detected by E48 (Ly-6D) Quantitative Reverse Transcription-Polymerase Chain Reaction , 2003, Laboratory Investigation.

[32]  A. Yuen,et al.  Elective neck dissection versus observation in the treatment of early oral tongue carcinoma , 1997, Head & neck.

[33]  K. Pitman,et al.  Sentinel lymph node biopsy in head and neck cancer. , 2003, Oral oncology.

[34]  G. Fletcher.  Irradiation of subclinical disease in the draining lymphatics. , 1984, International journal of radiation oncology, biology, physics.

[35]  J. Shah,et al.  Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. , 1990, American journal of surgery.

[36]  P. Comoglio,et al.  Staging of head and neck squamous cell carcinoma using the MET oncogene product as marker of tumor cells in lymph node metastases , 2000, International journal of cancer.

[37]  Michiel W M van den Brekel,et al.  Wait‐and‐see policy for the N0 neck in early‐stage oral and oropharyngeal squamous cell carcinoma using ultrasonography‐guided cytology: Is there a role for identification of the sentinel node? , 2002, Head & neck.

[38]  E. Sturgis,et al.  Second Primary Malignancies in the Head and Neck Cancer Patient , 1995, The Annals of otology, rhinology, and laryngology.

[39]  G. Snow,et al.  The Incidence of Micrometastases in Neck Dissection Specimens Obtained From Elective Neck Dissections , 1996, The Laryngoscope.

[40]  E. Yumoto,et al.  Genetic diagnosis of micrometastasis based on SCC antigen mRNA in cervical lymph nodes of head and neck cancer , 1999, Clinical & Experimental Metastasis.

[41]  G. Snow,et al.  False-positive and false-negative neck nodes. , 1985, Head & neck surgery.

[42]  C. R. Leemans,et al.  Histopathologic validation of the sentinel node concept in oral and oropharyngeal squamous cell carcinoma , 2005, Head & neck.

[43]  P. Yuen,et al.  Cervical lymph node metastatic patterns of squamous carcinomas in the upper aerodigestive tract , 1996, The Journal of Laryngology & Otology.

[44]  V. Schramm,et al.  The extracapsular spread of tumors in cervical node metastasis. , 1981, Archives of otolaryngology.

[45]  A. Shaha,et al.  The incidence of lymph node micrometastases in patients pathologically staged N0 in cancer of oral cavity and oropharynx. , 2002, Oral oncology.

[46]  W. Wei,et al.  Critical appraisal of watchful waiting policy in the management of N0 neck of advanced laryngeal carcinoma. , 1996, Archives of otolaryngology--head & neck surgery.

[47]  L. Harrison,et al.  Use of decision analysis in planning a management strategy for the stage N0 neck. , 1994, Archives of otolaryngology--head & neck surgery.

[48]  Jacques Bernier,et al.  Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. , 2004, The New England journal of medicine.

[49]  L. Delclos,et al.  Primary radiotherapy in the treatment of stage I and II oral tongue cancers: importance of the proportion of therapy delivered with interstitial therapy. , 1990, International journal of radiation oncology, biology, physics.

[50]  D. Lydiatt,et al.  Treatment of stage I and II oral tongue cancer , 1993, Head & neck.

[51]  D. Dunaway,et al.  A suggested method for sentinel node biopsy in squamous cell carcinoma of the head and neck , 1999, Head & neck.

[52]  J. Johnson,et al.  Effectiveness of selective neck dissection for management of the clinically negative neck. , 1997, Archives of otolaryngology--head & neck surgery.

[53]  D. Soutar,et al.  The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck , 2001, Cancer.

[54]  R. Esclamado,et al.  Oncologic effectiveness of selective neck dissection in the N0 irradiated neck , 2005, Head & neck.

[55]  M. Wax,et al.  Management of the N0 Neck During Salvage Laryngectomy , 1999, The Laryngoscope.

[56]  R. Lima,et al.  Supraomohyoid neck dissection in the treatment of T1/T2 squamous cell carcinoma of oral cavity. , 1994, American journal of surgery.

[57]  J. Valk,et al.  Occult metastatic neck disease: detection with US and US-guided fine-needle aspiration cytology. , 1991, Radiology.

[58]  J. Shah,et al.  The extent of neck disease after regional failure during observation of the N0 neck. , 1996, American journal of surgery.

[59]  M. Bullock,et al.  Sentinel lymph node biopsy in N0 squamous cell carcinoma of the oral cavity and oropharynx. , 2005, Archives of otolaryngology--head & neck surgery.

[60]  Petra Ambrosch,et al.  Elective and therapeutic selective neck dissection. , 2006, Oral oncology.