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When is post-op radiation not necessary for completely resected ipsilateral neck node recurrence in a previously UNirradiated neck?

For example: Initial primary of early stage completely resected oral cavity or oral tongue cancer with no adverse features and therefore did not get radiation, but now with single node recurrence. The NCCN Head and Neck guideline (Ver. 1.2015, ADV-3) states observation as an option for "no adverse features" resected recurrence. Are these "adverse features" extrapolated from the primary setting or validated in the recurrent setting? (This is somewhat of a follow up question to #565)
2 Answers
Mednet Member
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Radiation Oncology · University of Texas MD Anderson Cancer Center
Answered on

I think that in the case you described, a metachronous recurrence of nodal disease should be managed similarly to that of nodal disease presenting at the time of the primary disease.

Thus in the scenario presented, the same recommendations for dissected N1 disease apply. Historically, dissected N1 d...

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Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Memorial Sloan Kettering Cancer Center
Answered on

Always have to give RT. Typically this occurs with oral tongue with cancer within 12 months.

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