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[Are fixed cervical lymph node metastases always inoperable?].

E Fossion, H Harris

    Acta Chirurgica Belgica
    |March 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

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    Fixed lymph node metastases in head and neck cancer are operable. Neck exploration is worthwhile when the primary tumor is controlled, offering a chance for survival.

    Area of Science:

    • Oncology
    • Head and Neck Surgery
    • Radiation Oncology

    Context:

    • Large, fixed lymph node metastases in head and neck cancer present significant surgical challenges.
    • Preoperative radiotherapy is a common modality for managing advanced head and neck malignancies.

    Purpose:

    • To evaluate the operability and survival outcomes of head and neck cancer patients with large, fixed lymph node metastases treated with preoperative radiotherapy.
    • To determine if lymph node fixation is an absolute contraindication for surgical intervention.

    Summary:

    • A study involving 22 head and neck cancer patients with large, fixed lymph node metastases operated 3-8 weeks after 60 Gray preoperative radiotherapy was conducted.
    • Six patients achieved tumor-free survival exceeding 3 years, demonstrating that lymph node fixation does not preclude operability.

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  • Key surgical challenges include deep loco-regional invasion into the skull base, intervertebral foramina, and suprahyoid muscles, necessitating specialized approaches.

    • Impact:

    • Neck exploration is recommended when the primary tumor is controlled, as surgical intervention can lead to favorable survival outcomes.
    • Advances in reconstructive surgery and carotid artery management (ligation with EEG control or bypass) have improved surgical feasibility.
    • A specialized, potentially polydisciplinary approach is crucial for optimizing operability and survival in these complex cases.