Trial reportThe New England journal of medicine2016
PET-CT Surveillance versus Neck Dissection in Advanced Head and Neck Cancer.
Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph
Trial report in The New England journal of medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03926468 (Genetic Profiling by Liquid Biopsy for Initial Characterization and Response Monitoring of Head and Neck Squamous Cell Carcinoma), which is not on this map. Cited by 230 papers, 11 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
230citing papers in PubMed, 11 pooled it
58.4field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Genetic Profiling by Liquid Biopsy for Initial Characterization and Response Monitoring of Head and Neck Squamous Cell Carcinoma (HNSCC)
Who cites it
230 citing papers in PubMed, 11 syntheses or guidelines pooled it, 624 citations in OpenAlex.
- SEOM-TTCC clinical guidelines for the treatment of head and neck cancer (2025).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Guideline
- Evidence-based guideline diagnosis, treatment, prevention and aftercare of oropharyngeal and hypopharyngeal carcinoma.German medical science : GMS e-journal · 2025Guideline
- The landscape of circulating tumor HPV DNA and TTMV-HPVDNA for surveillance of HPV-oropharyngeal carcinoma: systematic review and meta-analysis.Journal of experimental & clinical cancer research : CR · 2024Pooled it
- Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment.The Cochrane database of systematic reviews · 2023Pooled it
- The psychosocial experiences of human papillomavirus (HPV) positive oropharyngeal cancer patients following (chemo)radiotherapy: A systematic review and meta-ethnography.Psycho-oncology · 2022Pooled it
- SEOM clinical guidelines for the treatment of head and neck cancer (2020).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2021Guideline
- Routine restaging after primary non-surgical treatment of laryngeal squamous cell carcinoma-a review.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Pooled it
- Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment.The Cochrane database of systematic reviews · 2018Pooled it
- What is the prognostic impact of FDG PET in locally advanced head and neck squamous cell carcinoma treated with concomitant chemo-radiotherapy? A systematic review and meta-analysis.European journal of nuclear medicine and molecular imaging · 2018Pooled it
- Accelerated vs. conventionally fractionated adjuvant radiotherapy in high-risk head and neck cancer: a meta-analysis.Radiation oncology (London, England) · 2018Pooled it
- FDG-PET/CT for treatment response assessment in head and neck squamous cell carcinoma: a systematic review and meta-analysis of diagnostic performance.European journal of nuclear medicine and molecular imaging · 2018Pooled it
- FDG-PET-Based Selective Deescalation of Chemoradiation in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma: A Multicenter Phase II Trial.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Trial
- [Cancer imaging : the official publication of the International Cancer Imaging Society · 2024Trial
- Initial Feasibility and Acute Toxicity Outcomes From a Phase 2 Trial ofInternational journal of radiation oncology, biology, physics · 2023Trial
- Trial
- Pre-CCRT 18-fluorodeoxyglucose PET-CT improves survival in patients with advanced stages p16-negative oropharyngeal squamous cell carcinoma via accurate radiation treatment planning.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2023Trial
- Trial
- Trial
- Phase II study of dichloroacetate, an inhibitor of pyruvate dehydrogenase, in combination with chemoradiotherapy for unresected, locally advanced head and neck squamous cell carcinoma.Investigational new drugs · 2022Trial
- Induction chemoimmunotherapy followed by CD8+ immune cell-based patient selection for chemotherapy-free radioimmunotherapy in locally advanced head and neck cancer.Journal for immunotherapy of cancer · 2022Trial
170 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
19 authors at 11 institutions in 2 countries.
Hisham MehannaFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Wai-Lup WongFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Christopher C McConkeyFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Joy K RahmanFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Max RobinsonFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Andrew G J HartleyFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Christopher NuttingFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Ned PowellFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Hoda Al-BoozFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Martin RobinsonFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Elizabeth JunorFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Mohammed RizwanullahFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Sandra V von ZeidlerFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Hulya WieshmannFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Claire HulmeFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Alison F SmithFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Peter HallFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
Janet DunnFrom the Institute of Head and Neck Studies and Education, University of Birmingham (H.M.), and University Hospitals Birmingham (A.G.J.H.), Birmingham, Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (W.-L.W.), Warwick Clinical Trials Unit, University of Warwick, Coventry (C.C.M., J.K.R., J.D.), Newcastle University, Newcastle upon Tyne (Max Robinson), Royal Marsden Hospital, London (C.N.), Cardiff University, Cardiff (N.P.), Bristol Haematology and Oncology Centre, Bristol (H.A.-B.), Weston Park Hospital, Sheffield (Martin Robinson), Western General Hospital, Edinburgh (E.J.), Beatson West of Scotland Cancer Centre, Glasgow (M. Rizwanullah), University of Liverpool, Liverpool (H.W.), and the Academic Unit of Health Economics, University of Leeds, Leeds (C.H., A.F.S., P.H.) - all in the United Kingdom; and the Pathology Department, Universidade Federal do Espírito Santo, Vitória, Brazil (S.V.Z.).
PET-NECK Trial Management Group
University of Leeds · GBUniversity of Warwick · GBAt Bristol · GBBeatson West of Scotland Cancer Centre · GBCardiff University · GBMount Vernon Hospital · GBRoyal Marsden Hospital · GBUniversidade Federal do Espírito Santo · BRUniversity of Birmingham · GBUniversity of Liverpool · GBWestern General Hospital · GB
Funding
Cancer Research UK C19677/A9674Department of Health 06/302/129Medical Research Council MR/N005872/1
Abstract
backgroundThe role of image-guided surveillance as compared with planned neck dissection in the treatment of patients with squamous-cell carcinoma of the head and neck who have advanced nodal disease (stage N2 or N3) and who have received chemoradiotherapy for primary treatment is a matter of debate.
methodsIn this prospective, randomized, controlled trial, we assessed the noninferiority of positron-emission tomography-computed tomography (PET-CT)-guided surveillance (performed 12 weeks after the end of chemoradiotherapy, with neck dissection performed only if PET-CT showed an incomplete or equivocal response) to planned neck dissection in patients with stage N2 or N3 disease. The primary end point was overall survival.
resultsFrom 2007 through 2012, we recruited 564 patients (282 patients in the planned-surgery group and 282 patients in the surveillance group) from 37 centers in the United Kingdom. Among these patients, 17% had nodal stage N2a disease and 61% had stage N2b disease. A total of 84% of the patients had oropharyngeal cancer, and 75% had tumor specimens that stained positive for the p16 protein, an indicator that human papillomavirus had a role in the causation of the cancer. The median follow-up was 36 months. PET-CT-guided surveillance resulted in fewer neck dissections than did planned dissection surgery (54 vs. 221); rates of surgical complications were similar in the two groups (42% and 38%, respectively). The 2-year overall survival rate was 84.9% (95% confidence interval [CI], 80.7 to 89.1) in the surveillance group and 81.5% (95% CI, 76.9 to 86.3) in the planned-surgery group. The hazard ratio for death slightly favored PET-CT-guided surveillance and indicated noninferiority (upper boundary of the 95% CI for the hazard ratio, <1.50; P=0.004). There was no significant difference between the groups with respect to p16 expression. Quality of life was similar in the two groups. PET-CT-guided surveillance, as compared with neck dissection, resulted in savings of £1,492 (approximately $2,190 in U.S. dollars) per person over the duration of the trial.
conclusionsSurvival was similar among patients who underwent PET-CT-guided surveillance and those who underwent planned neck dissection, but surveillance resulted in considerably fewer operations and it was more cost-effective. (Funded by the National Institute for Health Research Health Technology Assessment Programme and Cancer Research UK; PET-NECK Current Controlled Trials number, ISRCTN13735240.).
Indexed as
Neck DissectionPositron-Emission TomographyTomography, X-Ray ComputedCarcinoma, Squamous CellChemoradiotherapyFemaleFollow-Up StudiesHead and Neck NeoplasmsHumansIntention to Treat AnalysisKaplan-Meier EstimateLymphatic MetastasisMaleMiddle AgedNeoplasm Recurrence, LocalNeoplasm Staging
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NCT03926468ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.