Selective neck dissection for the treatment of neck metastasis from squamous cell carcinoma of the head and neck.

Abstract

OBJECTIVE:

Our objective was to determine the proportion of patients disease free in the neck, with the primary site controlled, who have been treated with a selective neck dissection (SND) for squamous cell carcinoma (SCCa) of the upper aerodigestive tract, and who had cervical metastasis less than 3 cm.

STUDY DESIGN:

A cohort of patients who fit the inclusion/exclusion criteria was identified retrospectively. Then all surviving patients were followed for a minimum of 2 years.

METHODS:

A group of 52 patients who had 58 selective neck dissections for cervical metastases from SCCa of the upper aerodigestive tract were identified. The mean age was 56 years (range, 20-85 y), there were 40 males and 12 females, and mean follow-up was 24.5 months (range, 1-64 mo). Twenty-six patients had clinically negative (cNo) neck examinations and 26 had clinically positive neck examinations. Postoperative radiation was given for extracapsular spread, greater than 2 positive nodes, T3, T4, or recurrent disease if the patient had not received radiation before surgery. These radiation criteria excluded 18 patients from postoperative radiation treatment.

RESULTS:

Kaplan-Meier survival analysis showed that the regional control rate with the primary site controlled was 0.94. Six patients developed recurrent neck disease. Three of these 6 patientswere surgically salvaged. Four recurrences were in the dissected field and 2 were out of the dissected field (level V).

CONCLUSIONS:

With similar indications for radiation therapy, the regional control rate in this cohort is comparable to control rates obtained with modified radical neck dissection.

• Authors: Douglas B Chepeha, Paul T Hoff, Rodney J Taylor, Carol R Bradford, Theodoros N Teknos, Ramon M Esclamado
• Journal: The Laryngoscope (Laryngoscope) Vol. 112 Issue 3 Pg. 434-8 (Mar 2002) ISSN: 0023-852X [Print] United States
• PMID: 12148849 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Squamous Cell (pathology, surgery)
• Disease-Free Survival
• Female
• Head and Neck Neoplasms (pathology, surgery)
• Humans
• Lymphatic Metastasis
• Male
• Middle Aged
• Neck Dissection (methods)
• Neoplasm Recurrence, Local
• Retrospective Studies
• Treatment Outcome