Evidence map›Paper›PMID 36575528›Full record

ArticleJournal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale2022

Evaluating contralateral neck failure in patients with lateralized OPSCC treated with transoral robotic surgery and neck management based on pre-operative SPECT-CT lymphatic mapping.

Ilyes Berania, Ali Hosni, Carissa M Thomas, David Goldstein, Andrew Bayley, Ravi Mohan, Aaron Hendler, Richard M Cooper, John R de Almeida

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 26% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. 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

9 authors at 2 institutions in 1 country.

Ilyes BeraniaDepartment of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, 610 University Avenue, Suite 3-950, Toronto, ON, M5G 2M9, Canada.
Ali HosniDepartment of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Carissa M ThomasDepartment of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, 610 University Avenue, Suite 3-950, Toronto, ON, M5G 2M9, Canada.
David GoldsteinDepartment of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, 610 University Avenue, Suite 3-950, Toronto, ON, M5G 2M9, Canada.
Andrew BayleyDepartment of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Ravi MohanDepartment of Nuclear Medicine, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.
Aaron HendlerDepartment of Nuclear Medicine, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.
Richard M CooperDepartment of Anesthesia, University of Toronto, Toronto, ON, Canada.
John R de AlmeidaDepartment of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, 610 University Avenue, Suite 3-950, Toronto, ON, M5G 2M9, Canada. john.dealmeida@uhn.ca.ORCID http://orcid.org/0000-0002-1546-5033
University Health Network · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRisk of contralateral nodal metastases in oropharyngeal squamous cell carcinoma (OPSCC) is relatively low, however, many OPSCC patients receive bilateral neck treatment. This study evaluates the oncological outcomes with management of the contralateral cN0 neck based on lymphatic mapping with single photon emission computed tomography (SPECT-CT).

methodsRetrospective evaluation of patients with lateralized cT1-2 and contralateral cN0 OPSCC treated with primary surgery between December 2017 and October 2019. All patients underwent pre-operative lymphatic mapping using SPECT-CT. Clinical parameters including demographics, tumor characteristics and oncological outcomes were recorded.

resultsThirteen patients underwent primary site resection with transoral robotic surgery (TORS) and ipsilateral neck dissection with or without adjuvant therapy. Twelve patients (92.3%) had ipsilateral drainage on SPECT-CT, whereas 1 (7.7%) patient had bilateral neck lymphatic drainage. Four patients (30.8%) underwent post-operative radiation therapy (PORT). Three patients with unilateral drainage on SPECT-CT underwent PORT with unilateral neck irradiation, and 1 patient with bilateral drainage underwent PORT with bilateral neck irradiation. Seven (53.8%) patients were staged as pT1, 6 (46.2%) patients as pT2, 6 (46.2%) patients were pN0, 3 (23.1%) patients were pN1, 1 (7.7%) patient was pN2a for and 3 (23.1%) patients were N2b. The median distance of the tumor from midline was 1.05 cm (0.0-1.58). Primary sites included tonsil (n = 10, 76.9%) and tongue base (n = 3, 23.1%). The median follow-up time was 15.4 months. All patients were disease free at the latest follow-up with no contralateral neck failures.

conclusionsPre-operative mapping of lymphatic drainage in early stage OPSCC with SPECT-CT is a promising tool which can reduce treatment to the contralateral neck potentially without compromising oncological outcomes.

Indexed as

Head and Neck NeoplasmsOropharyngeal NeoplasmsRobotic Surgical ProceduresHumansLymphatic MetastasisNeoplasm StagingRetrospective StudiesSquamous Cell Carcinoma of Head and NeckTomography, Emission-Computed, Single-PhotonTomography, X-Ray ComputedLymphoscintigraphyNeck dissectionOropharyngeal squamous cell carcinomaSentinel lymph node biopsySPECT-CTTransoral robotic surgery

Identifiers

PMID36575528
PMCPMC9795590
OpenAlexW4313249948

What OpenQuestion holds

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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.