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Neck Cancer

Surgery Management of Lymph Node Metastases. January 28, 2006. STATEMENTS ON. Head and. Neck Cancer. Frankfurt am Main, Germany. Surgery Management of Lymph Node Metastases. Moderator – Jatin Shah. Speaker – Jochen Werner. Panelists – Klaus Ehrenberger

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Neck Cancer

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  1. SurgeryManagement of Lymph Node Metastases January 28, 2006 STATEMENTS ON Head and Neck Cancer Frankfurt am Main, Germany

  2. SurgeryManagement of Lymph Node Metastases Moderator – Jatin Shah Speaker – Jochen Werner Panelists – Klaus Ehrenberger Miljenko Bura Jeffrey Myers

  3. Management of Lymph Node Metastases Jochen Werner, M.D.

  4. Cancer of the Head & Neck The success of the treatment of head and neck cancer is directly related to the STAGE of the tumor at the time of treatment.

  5. Cancer of the Head & Neck The single most important prognostic factor in squamous carcinoma of the head and neck is the status of the CERVICAL LYMPH NODES.

  6. Five Year Survival Rates in Patients with SCC of the Upper Aerodigestive Tract in Relation to the Extent of Disease

  7. Incidence Nodal Factors Affecting Prognosis ‘N’ Staging (AJCC-UICC-2002) Diagnostic Imaging Management of the N+ Neck Management of the N0 Neck Adjuvant Therapy The Post Chemo/R.T. Neck Future Strategies Current Issues in the Management of the Neck

  8. N0 Neck 1. Risk of Occult Metastases 2. Patterns of Neck Metastases 3. Means of Identification of Occult Metastases 4. Means of Treatment of Occult Metastases 5. Extent of Treatment for Occult Metastases 6. Outcomes of Treatment of Occult Metastases

  9. Preoperative 99mTC Labeled Sulfur Colloid Scan Showing Sentinel Node in the Left Lower Neck

  10. The Hand-held Gamma Probe

  11. Blue Colored Sentinel Node which also had a High Radioactive Count

  12. Increasing Accuracy of Identifying Occult Metastasis by Various Pathologic Techniques

  13. Assessment of Neck Nodes After RT or Chemo/RT • Clinical • Structural (CT/MRI) • Functional (PET)

  14. PCRT (Post Chemo-Radiotherapy) Neck Node Protocol (N+) Chemo/RT (6 wks) Poor response Good response (? Induration) 6 wks ND (CND? Or SND?) PET scan Positive ND (CND? Or SND?) Negative observe

  15. N+ Neck 1. Means of Identification of Extent of Nodal Metastases 2. Means of Treatment of Gross Metastases 3. Extent of Treatment for Gross Metastases 4. Indications for Adjuvant Treatment 5. Means of Adjuvant Treatment RT vs Chemo/RT 6. Complications/Sequelae of Treatment 7. Outcomes of Treatment for Gross Metastases

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