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Master Thesis

Intérêt des évidements ganglionnaires cervicaux associés à une laryngectomie totale en situation de rattrapage

Abstract : Objectives.- To evaluate the incidence of neck metastasis through histopathological analysis of elective neck dissection in patients staged rN0 who underwent total salvage laryngectomy after radiotherapy . To analyse morbidity and mortality for these patients. Materials and Methods - Retrospective single-centre study on data from patients who received total salvage laryngectomy between 2005 and 2020, after radiotherapy treatment for recurrence or progression of a laryngeal or hypopharyngeal cancer staged rN0. Results.- 33 patients were included in this study, 26 (79%) had laryngeal and 7 (21%) hypopharyngeal cancer. The majority of patients were staged T3 either at the time of the initial cancer (63%) or at the time of tumour recurrence (58%). The rate of occult neck metastasis found in histopathological analysis was 6%. In the** multivariate analysis, no predictive factor for the occurrence of neck metastasis was found. Ten patients (30%) had an exteriorised cervical fistula. Post-surgery follow-up was on average 41 months. Overall and specific survival at 3 years was 62%. Conclusion.- The rate of occult neck metastasis in total salvage laryngectomy was low, which is consistent with results from the literature. However, general recommendations for utility of a systematic selective neck dissection cannot be made. Indeed, only a prospective randomised analysis with a control group without elective neck dissection would answer the question raised.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02939558
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Submitted on : Tuesday, September 15, 2020 - 4:38:38 PM
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Claire Sandré. Intérêt des évidements ganglionnaires cervicaux associés à une laryngectomie totale en situation de rattrapage. Médecine humaine et pathologie. 2020. ⟨dumas-02939558⟩

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