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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 JIArch Otolaryngol Head Neck Surg 2002[Oct]; 128 (10): 1180-4BACKGROUND: 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.|*Lymph Node Excision[MESH]|*Outcome Assessment, Health Care[MESH]|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Carcinoma, Squamous Cell/mortality/*secondary/*surgery[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Head and Neck Neoplasms/mortality/*pathology/*surgery[MESH]|Humans[MESH]|Lymphatic Metastasis/*pathology[MESH]|Male[MESH]|Middle Aged[MESH]|Neoplasm Recurrence, Local/mortality/*pathology[MESH]|Neoplasm Staging[MESH]|Retrospective Studies[MESH]|Survival Rate[MESH]|Time Factors[MESH] |
