PHOENIX-Just how useful are PET or PET-CT in identifying residual occult nodal disease in patients with head and neck cancer? Two presentations at the 2009 Combined Otolaryngology Spring Meeting addressed this topic. In one, researchers suggested that delaying PET-CT may work to help reduce the number of planned neck dissections. In the other, researchers said that PET-CT does have a role to play in head and neck patients, but cannot replace neck dissection as a staging tool.
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September 2009Christine Gourin, MD, Associate Professor of Otolaryngology-Head and Neck Surgery at Johns Hopkins University in Baltimore, presented details of a retrospective study of patients treated for head and neck squamous cell cancer (HNSCC).
The role of PET-CT in detecting residual occult nodal disease in patients following chemoradiation is controversial, she said. Generally, what is advocated is a planned post-treatment neck dissection-regardless of clinical response to chemoradiation. Proponents of neck dissection argue that there is a high incidence of residual occult disease found in histopathological evaluations of samples from neck dissection, and that the procedure leads to better regional control rates. Opponents, however, maintain that there are low regional recurrence rates in patients with a complete response who are not treated with neck dissection, and that there is no change in survival in most patients by adding neck dissection.