Evidence map›Paper›PMID 27841133›Full record

GuidelineThe Journal of laryngology and otology2016

Management of neck metastases in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.

V Paleri, T G Urbano, H Mehanna, C Repanos, J Lancaster, T Roques, M Patel, M Sen

Open access · hybridAbstract readPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in The Journal of laryngology and otology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 3 pooled it
6.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 98 citations in OpenAlex.

  1. Pooled it
  2. Elective neck dissection in T1/T2 oral squamous cell carcinoma with N0 neck: essential or not? A systematic review and meta-analysis.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2020
    Pooled it
  3. Pooled it
  4. Multicenter Trial of [Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2019
    Trial
  5. Factors associated with occult ipsilateral and contralateral nodal metastasis in resectable lateralized laryngeal and hypopharyngeal malignancies.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. Non-melanoma skin cancer of the external auditory canal: long-term outcomes of a tertiary head and neck unit.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Observational
  12. Automated Segmentation of Lymph Nodes on Neck CT Scans Using Deep Learning.Journal of imaging informatics in medicine · 2024
    Article
  13. Review
  14. Imaging for Laryngeal Malignancies: Guidelines for Clinicians.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2023
    Article
  15. Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 8 institutions in 1 country.

V PaleriDepartment of Otolaryngology - Head and Neck Surgery,The Newcastle upon Tyne Hospitals NHS Foundation Trust, Northern Institute of Cancer Research,Newcastle upon Tyne,UK.
T G UrbanoDepartment of Oncology,Guy's and St Thomas' Hospitals,London,UK.
H MehannaInstitute of Head and Neck Studies and Education, University of Birmingham, University Hospital,Birmingham,UK.
C RepanosDepartment of Otolaryngology - Head and Neck Surgery,Queen Alexandra Hospital,Portsmouth,UK.
J LancasterDepartment of Otolaryngology - Head and Neck Surgery,University Hospital Aintree,Liverpool,UK.
T RoquesDepartment of Clinical Oncology,Norfolk and Norwich University Hospital,Norwich,UK.
M PatelDepartment of Oral and Maxillofacial Surgery,University Hospital of South Manchester NHS Foundation Trust,Manchester,UK.
M SenDepartment of Clinical Oncology,St James's Institute of Oncology,Leeds,UK.
Aintree University Hospital · GBInstitute of Cancer Research · GBManchester University NHS Foundation Trust · GBNorfolk and Norwich University Hospital · GBQueen Alexandra Hospital · GBSt James's University Hospital · GBSt Thomas' Hospital · GBUniversity of Birmingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. A rational plan to manage the neck is necessary for all head and neck primaries. With the emergence of new level 1 evidence across several domains of neck metastases, this guideline will identify the evidence-based recommendations for management. Recommendations • Computed tomographic or magnetic resonance imaging is mandatory for staging neck disease, with choice of modality dependant on imaging modality used for the primary site, local availability and expertise. (R) • Patients with a clinically N0 neck, with more than 15-20 per cent risk of occult nodal metastases, should be offered prophylactic treatment of the neck. (R) • The treatment choice of for the N0 and N+ neck should be guided by the treatment to the primary site. (G) • If observation is planned for the N0 neck, this should be supplemented by regular ultrasonograms to ensure early detection. (R) • All patients with T1 and T2 oral cavity cancer and N0 neck should receive prophylactic neck treatment. (R) • Selective neck dissection (SND) is as effective as modified radical neck dissection for controlling regional disease in N0 necks for all primary sites. (R) • SND alone is adequate treatment for pN1 neck disease without adverse histological features. (R) • Post-operative radiation for adverse histologic features following SND confers control rates comparable with more extensive procedures. (R) • Adjuvant radiation following surgery for patients with adverse histological features improves regional control rates. (R) • Post-operative chemoradiation improves regional control in patients with extracapsular spread and/or microscopically involved surgical margins. (R) • Following chemoradiation therapy, complete responders who do not show evidence of active disease on co-registered positron emission tomography-computed tomography (PET-CT) scans performed at 10-12 weeks, do not need salvage neck dissection. (R) • Salvage surgery should be considered for those with incomplete or equivocal response of nodal disease on PET-CT. (R).

Indexed as

AlgorithmsChemoradiotherapyCombined Modality TherapyHead and Neck NeoplasmsHumansInterdisciplinary CommunicationMagnetic Resonance ImagingNeck DissectionNeoplasm Recurrence, LocalNeoplasm StagingPalliative CareSentinel Lymph Node BiopsyTomography, X-Ray ComputedUnited Kingdom

Identifiers

PMID27841133
PMCPMC4873907
OpenAlexW2367595001

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.