{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:27:27Z","timestamp":1770812847129,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The role of elective neck dissection (END) during salvage total laryngectomy (STL) in clinically node\u2010negative (cN0) patients remains controversial due to variable risks of occult nodal metastasis and surgical morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter retrospective study of 178 cN0 patients undergoing STL after radiotherapy (RT) or chemoradiotherapy (CRT). Rates of occult nodal disease, survival outcomes, and predictive factors were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Occult nodal metastases were found in 19.7% of cases, highest in hypopharyngeal (35.7%) and supraglottic (24.5%) tumors. Tumor subsite and lymphovascular invasion were independent predictors of nodal positivity, while prior chemotherapy reduced risk. Patients with occult nodal disease had significantly worse three\u2010year overall and disease\u2010specific survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A risk\u2010adapted approach to END in STL is recommended, particularly for supraglottic and hypopharyngeal tumors. Routine END may be unnecessary in low\u2010risk subsites like glottic tumors. Prospective studies are needed to refine management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70072","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T01:38:22Z","timestamp":1760405902000},"page":"722-732","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Risk\u2010Adapted Approach for Elective Neck Dissection in Salvage Total Laryngectomy: Revisiting the Role of Tumor Subsite and Occult Nodal Disease"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9454-9464","authenticated-orcid":false,"given":"Carlos M.","family":"Chiesa\u2010Estomba","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Donostia University Hospital  San Sebasti\u00e1n Spain"},{"name":"Faculty of Medicine Deusto University  Bilbao Spain"},{"name":"Head &amp; Neck Study Group of Young\u2010Otolaryngologists of the International Federations of Oto\u2010Rhino\u2010Laryngological Societies YO\u2010IFOS  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Melkane","sequence":"additional","affiliation":[{"name":"Head &amp; Neck Study Group of Young\u2010Otolaryngologists of the International Federations of Oto\u2010Rhino\u2010Laryngological Societies YO\u2010IFOS  Paris France"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Hotel Dieu de France Hospital Saint Joseph University  Beirut Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier","family":"Dequanter","sequence":"additional","affiliation":[{"name":"Head &amp; Neck Study Group of Young\u2010Otolaryngologists of the International Federations of Oto\u2010Rhino\u2010Laryngological Societies YO\u2010IFOS  Paris France"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery CHU Saint\u2010Pierre  Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aina","family":"Brunet","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Hospital Universitari Bellvitge  Barcelona Espa\u00f1a"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1251-0185","authenticated-orcid":false,"given":"Antonino","family":"Maniaci","sequence":"additional","affiliation":[{"name":"Head &amp; Neck Study Group of Young\u2010Otolaryngologists of the International Federations of Oto\u2010Rhino\u2010Laryngological Societies YO\u2010IFOS  Paris France"},{"name":"Department of Medicine and Surgery University Enna Kore  Enna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khawla","family":"Karra","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montreal Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-0845","authenticated-orcid":false,"given":"Jerome R.","family":"Lechien","sequence":"additional","affiliation":[{"name":"Head &amp; Neck Study Group of Young\u2010Otolaryngologists of the International Federations of Oto\u2010Rhino\u2010Laryngological Societies YO\u2010IFOS  Paris France"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery CHU Saint\u2010Pierre  Brussels Belgium"},{"name":"Department of Surgery University of Mons  Mons Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulina","family":"Droppelman\u2010Alvarez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Donostia University Hospital  San Sebasti\u00e1n Spain"},{"name":"Faculty of Medicine Deusto University  Bilbao Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amaya","family":"Roldan\u2010Fidalgo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Hospital Universitario Son Llatzer  Palma de Mallorca Espa\u00f1a"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Palacios","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Virgen Macarena University Hospital  Seville Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Baguda","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Hospital Universitari Bellvitge  Barcelona Espa\u00f1a"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tareck","family":"Ayad","sequence":"additional","affiliation":[{"name":"Head &amp; 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