Medline ® Abstract for Reference 27
of 'Treatment of locoregionally advanced (stage III and IV) head and neck cancer: The oral cavity'
Results of selective neck dissection in management of the node-positive neck.
Andersen PE, Warren F, Spiro J, Burningham A, Wong R, Wax MK, Shah JP, Cohen JI
Arch Otolaryngol Head Neck Surg. 2002;128(10):1180.
BACKGROUND: Although increasingly accepted in treatment of the N0 neck, use of selective neck dissection in patients with node-positive squamous cell carcinoma of the head and neck remains controversial.
OBJECTIVE: To determine the oncologic efficacy of selective node dissection in patients with node-positive squamous carcinoma of the head and neck.
SETTING: Three tertiary care academic/Veterans Affairs medical centers.
METHODS: Ten-year retrospective medical chart review of 106 previously untreated clinically and pathologically node-positive patients undergoing 129 selective neck dissections and followed for a minimum of 2 years or until patient death.
RESULTS: Regional metastasis was clinically staged as N1 in 58 patients (54.7%), N2a in 5 (4.7%), N2b in 28 (26.4%), N2c in 14 (13.2%), and N3 in 1 (0.9%). Extracapsular extension of tumor was present in 36 patients (34.0%), and postoperative radiation therapy was administered to 76 patients (71.7%). Overall, 9 patients experienced disease recurrence in the neck. Six of these recurrences were in the side of the neck that had undergone selective neck dissection, for a regional control rate of 94.3%.
CONCLUSIONS: These results support the use of selective neck dissection in carefully selected patients with clinically node-positive squamous cell carcinoma of the head and neck region. Regional control rates comparable to those achieved with comprehensive operations can be achieved in appropriately selected patients.
Department of Otolaryngology/Head and Neck Surgery, Oregon Health Sciences University, Portland 97201, USA.