Lack of Adjuvant Radiotherapy May Increase Risk of Retropharyngeal Node Recurrence in Patients with Squamous Cell Carcinoma of the Head and Neck after Transoral Robotic Surgery

Purpose. Transoral robotic surgery (TORS) has increased in popularity in the management of squamous cell carcinoma of the head and neck. However, TORS does not address the neck or retropharyngeal nodes (RPN). In the current report, we highlight the impact of the lack of adjuvant radiotherapy on RPN...

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Main Authors: Waleed F. Mourad, Dukagjin M. Blakaj, Rafi Kabarriti, Rebekah Young, Rania A. Shourbaji, Jonathan Glanzman, Shyamal Patel, Ravindra Yaparpalvi, Shalom Kalnicki, Madhur K. Garg
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Oncological Medicine
Online Access:http://dx.doi.org/10.1155/2013/727904
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author Waleed F. Mourad
Dukagjin M. Blakaj
Rafi Kabarriti
Rebekah Young
Rania A. Shourbaji
Jonathan Glanzman
Shyamal Patel
Ravindra Yaparpalvi
Shalom Kalnicki
Madhur K. Garg
author_facet Waleed F. Mourad
Dukagjin M. Blakaj
Rafi Kabarriti
Rebekah Young
Rania A. Shourbaji
Jonathan Glanzman
Shyamal Patel
Ravindra Yaparpalvi
Shalom Kalnicki
Madhur K. Garg
author_sort Waleed F. Mourad
collection DOAJ
description Purpose. Transoral robotic surgery (TORS) has increased in popularity in the management of squamous cell carcinoma of the head and neck. However, TORS does not address the neck or retropharyngeal nodes (RPN). In the current report, we highlight the impact of the lack of adjuvant radiotherapy on RPN recurrence after TORS. Materials and Methods. A 58-year-old Caucasian male presented with squamous cell carcinoma of the head and neck of unknown primary. He was offered radiotherapy as a definitive management for clinical stage T0N2aM0, stage IVA, but he opted to left neck dissection. Follow-up PET-CT scan revealed recurrence in the left base of tongue and right level II lymph node. He was offered radiotherapy which he declined and opted to TORS and right neck dissection. Follow-up PET-CT scan showed recurrence in left RPN for which he underwent salvage concurrent chemoradiotherapy to 70 Gy. Results. After a followup of 9 months from the date of salvage chemoradiotherapy completion, the patient is with no evidence of disease. Conclusions. TORS followed by adjuvant radiotherapy seems reasonable in the context of squamous cell carcinoma of the head and neck due to the odds of RPN involvement. Further reports are warranted to optimize post-TORS adjuvant treatment.
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spelling doaj-art-e6057b68b90a47e09164ffcaf05d68062025-02-03T06:12:42ZengWileyCase Reports in Oncological Medicine2090-67062090-67142013-01-01201310.1155/2013/727904727904Lack of Adjuvant Radiotherapy May Increase Risk of Retropharyngeal Node Recurrence in Patients with Squamous Cell Carcinoma of the Head and Neck after Transoral Robotic SurgeryWaleed F. Mourad0Dukagjin M. Blakaj1Rafi Kabarriti2Rebekah Young3Rania A. Shourbaji4Jonathan Glanzman5Shyamal Patel6Ravindra Yaparpalvi7Shalom Kalnicki8Madhur K. Garg9Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USADepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USADepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USADepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USADepartment of Radiation Oncology, Beth Israel Medical Center, New York, NY 10003, USADepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USADepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USADepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USADepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USADepartment of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USAPurpose. Transoral robotic surgery (TORS) has increased in popularity in the management of squamous cell carcinoma of the head and neck. However, TORS does not address the neck or retropharyngeal nodes (RPN). In the current report, we highlight the impact of the lack of adjuvant radiotherapy on RPN recurrence after TORS. Materials and Methods. A 58-year-old Caucasian male presented with squamous cell carcinoma of the head and neck of unknown primary. He was offered radiotherapy as a definitive management for clinical stage T0N2aM0, stage IVA, but he opted to left neck dissection. Follow-up PET-CT scan revealed recurrence in the left base of tongue and right level II lymph node. He was offered radiotherapy which he declined and opted to TORS and right neck dissection. Follow-up PET-CT scan showed recurrence in left RPN for which he underwent salvage concurrent chemoradiotherapy to 70 Gy. Results. After a followup of 9 months from the date of salvage chemoradiotherapy completion, the patient is with no evidence of disease. Conclusions. TORS followed by adjuvant radiotherapy seems reasonable in the context of squamous cell carcinoma of the head and neck due to the odds of RPN involvement. Further reports are warranted to optimize post-TORS adjuvant treatment.http://dx.doi.org/10.1155/2013/727904
spellingShingle Waleed F. Mourad
Dukagjin M. Blakaj
Rafi Kabarriti
Rebekah Young
Rania A. Shourbaji
Jonathan Glanzman
Shyamal Patel
Ravindra Yaparpalvi
Shalom Kalnicki
Madhur K. Garg
Lack of Adjuvant Radiotherapy May Increase Risk of Retropharyngeal Node Recurrence in Patients with Squamous Cell Carcinoma of the Head and Neck after Transoral Robotic Surgery
Case Reports in Oncological Medicine
title Lack of Adjuvant Radiotherapy May Increase Risk of Retropharyngeal Node Recurrence in Patients with Squamous Cell Carcinoma of the Head and Neck after Transoral Robotic Surgery
title_full Lack of Adjuvant Radiotherapy May Increase Risk of Retropharyngeal Node Recurrence in Patients with Squamous Cell Carcinoma of the Head and Neck after Transoral Robotic Surgery
title_fullStr Lack of Adjuvant Radiotherapy May Increase Risk of Retropharyngeal Node Recurrence in Patients with Squamous Cell Carcinoma of the Head and Neck after Transoral Robotic Surgery
title_full_unstemmed Lack of Adjuvant Radiotherapy May Increase Risk of Retropharyngeal Node Recurrence in Patients with Squamous Cell Carcinoma of the Head and Neck after Transoral Robotic Surgery
title_short Lack of Adjuvant Radiotherapy May Increase Risk of Retropharyngeal Node Recurrence in Patients with Squamous Cell Carcinoma of the Head and Neck after Transoral Robotic Surgery
title_sort lack of adjuvant radiotherapy may increase risk of retropharyngeal node recurrence in patients with squamous cell carcinoma of the head and neck after transoral robotic surgery
url http://dx.doi.org/10.1155/2013/727904
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