A trial looking at the treatment of local cancer spread in head and neck cancers

Cancer type:

Head and neck cancers
Laryngeal cancer
Mouth (oral) cancer
Nasal and paranasal sinus cancer
Nasopharyngeal cancer
Pharyngeal cancer




Phase 3

This trial compared surgery to remove lymph nodes in squamous cell cancers of the head and neck with a ‘watch and wait’ policy using PET-CT scanning.

More about this trial

Chemoradiation Open a glossary item is the usual treatment for squamous cell Open a glossary item cancer of the head and neck that has spread to the lymph nodes. This is usually followed by surgery to remove remaining cancer cells in the lymph nodes Open a glossary item in the neck. This is called a neck dissection.

Some people don’t have any cancer in their lymph nodes after chemoradiation and don’t need surgery. But when this trial was done, there was no reliable way to identify which people still had remaining cancer cells. Doctors thought a new type of scanner called a PET-CT could help to see if there were any cancer cells in the lymph nodes.

The aims of the trial were to

  • find out if PET-CT scanning after chemoradiation could help this group of people
  • find out more about quality of life Open a glossary item and cost

Summary of results

The trial team found that PET-CT scanning was very useful. It can prevent unnecessary operations and better target areas of cancer in the small number of people who do need surgery.

564 people took part. After chemoradiation, they were put into 1 of 2 treatment groups at random

  • 282 to have neck dissection surgery as usual. This was called the control group
  • 282 to have a PET-CT scan. This was called the surveillance group. They went on to have surgery if the scan found cancer cells.

Trial Diagram

The trial team looked at who had surgery. This was

  • 221 people in the control group
  • 54 people in the surveillance group

They compared

  • the number of people living 2 years after treatment had finished. This is called overall survival
  • quality of life

They found there was no difference between the 2 different groups in either of these.  

The researchers concluded that

  • there was no difference in overall survival between the control group and the surveillance group
  • having a PET-CT resulted in fewer operations and this was more cost effective

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Hisham Mehanna

Supported by

Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer
NIHR Health Technology Assessment (HTA) programme
University Hospitals Coventry and Warwickshire
University of Warwick

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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