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Letters to the Editor
October 20, 2008

Selecting Patients for Planned Neck Dissection After Chemoradiotherapy in Regionally Advanced Head and Neck Cancer—Reply

Arch Otolaryngol Head Neck Surg. 2008;134(10):1122. doi:10.1001/archotol.134.10.1122

In reply

The issue of planned neck dissection after chemoradiation therapy for the N2-N3 neck remains a contentious issue. My colleagues and I recognize the limitations of our retrospective analysis. Nodal diameter was analyzed in our data, and it was not predictive of recurrence after chemoradiation therapy if the patient had a CR. Extracapsular extension was not analyzed, because our patient data set contained only patients diagnosed by fine-needle aspiration biopsy. Patients who underwent neck dissections or nodal excisions before chemoradiation therapy were excluded from our analysis. There were too few cases involving N3 disease (n = 5) in our cohort to comment on this patient group.

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