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Image-Guided PET-CT Surveillance Can Be as Effective as Neck Dissection for Advanced Head and Neck Cancer

By MedImaging International staff writers
Posted on 29 Mar 2016

The results of a recent study show that the survival rates of patients with advanced head and neck squamous-cell carcinoma, was similar for those diagnosed using PET-CT guided surveillance, and those who underwent a planned neck dissection.

The use of the different techniques for the treatment of patients with advanced head and neck squamous-cell carcinoma nodal disease (stage N2 or N3) who have undergone chemoradiotherapy for primary treatment, is unclear and under debate.

The primary end point of the prospective, randomized, controlled trial was to assess overall survival rates, and the non-inferiority of Positron-Emission Tomography-Computed Tomography (PET-CT) guided surveillance when compared with planned neck dissection for patients with stage N2 or N3 carcinoma nodal disease.

The researchers used data gathered by the UK Warwick Clinical Trials Unit. Tissue samples were collected and stained for the p16 protein at the University of Birmingham (Birmingham, UK). The study lasted from 2007 to 2012, and included 564 patients from 37 centers in the UK. Seventeen percent of the patients had nodal stage N2a disease, while 61% had stage N2b disease.

The results showed that the use of PET-CT guided surveillance resulted in significantly less neck dissections (54) compared to planned dissection surgery (221). Surgical complications were similar in both groups. The 2-year overall survival rate was 84.9% for those patients undergoing PET-CT surveillance, and 81.5% for those that underwent planned-surgery. In addition, savings of UKP 1,492 per patient were realized per patient, for the duration of the trial, when PET-CT guided surveillance was used instead of neck dissection.

The researchers concluded that survival rates for patients who underwent planned neck dissection were similar to those that underwent PET-CT guided surveillance, and that imaging surveillance resulted in significantly less operations than neck dissection, and was more cost-effective.

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67 (272.98927307129): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

68 (68.902969360352): select jos_twitters.link from jos_twitters where cat=10

69 (31.948089599609): select jos_facebook.link from jos_facebook where cat=10

70 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

71 (28.848648071289): select jos_linkedin.link from jos_linkedin where cat=10

72 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294763453 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294763453 AND published='1' LIMIT 1

73 (30.994415283203): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

74 (231.98127746582): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294763453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (240.08750915527): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294763453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (56.982040405273): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

77 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (41.007995605469): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294763453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (31.948089599609): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294763453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

93 (30.994415283203): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

94 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

109 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

110 (53.882598876953): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294763453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (48.87580871582): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294763453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

113 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

114 (56.028366088867): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294763453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (512.12310791016): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294763453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (689.98336791992): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (375.03242492676): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

118 (78.201293945312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

119 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

120 (98.943710327148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

121 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

122 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

123 (38.14697265625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

124 (234.84230041504): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 17161.846160889): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

126 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

127 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

128 (392.19856262207): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294763453 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294763453 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 446835.04104614): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (87.976455688477): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

131 (46.968460083008): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

132 (28.848648071289): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

133 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

134 (28.133392333984): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

135 (28.133392333984): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

136 (29.802322387695): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

137 (540.01808166504): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (396.9669342041): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (221.96769714355): SELECT name FROM jos_deeppockets WHERE id=213

140 (38.14697265625): SELECT name FROM jos_deeppockets WHERE id=213

141 (525.95138549805): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (365.01884460449): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

144 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

145 (!!!!! 8793.1156158447): TRUNCATE TABLE jos_trademed_module

146 (92.983245849609): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294763453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (71.048736572266): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294763453 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (905.99060058594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

151 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

152 (!!!!! 1086.950302124): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

153 (55.789947509766): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

154 (42.200088500977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

155 (48.160552978516): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294763453 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294763453 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (383.13865661621): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

157 (38.14697265625): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

158 (30.994415283203): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (135.18333435059): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

160 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763453 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763453 AND published='1' LIMIT 1

161 (41.007995605469): select jos_twitters.link from jos_twitters where cat=10

162 (32.186508178711): select jos_facebook.link from jos_facebook where cat=10

163 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

164 (32.901763916016): select jos_linkedin.link from jos_linkedin where cat=10

165 (236.98806762695): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

166 (!!!!! 1287.9371643066): insert into jos_banners_delta values (14615,'2025-05-01 23:46:49','13.58.214.82','view'),(14202,'2025-05-01 23:46:49','13.58.214.82','view'),(14203,'2025-05-01 23:46:49','13.58.214.82','view')

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