The extent of neck disease after regional failure during observation of the N(0) neck Conference Paper
| Authors: | Andersen, P. E.; Jose, E. C.; Shaha, A. R.; Shah, J. P. |
| Title: | The extent of neck disease after regional failure during observation of the N(0) neck |
| Conference Title: | 4th International Conference on Head and Neck Cancer |
| Abstract: | BACKGROUND: The optimum management of the N 0 neck remains controversial. When the neck is observed it is hoped that close follow-up will detect regional failure at an early stage. To test this hypothesis we examined patients undergoing therapeutic neck dissection for newly developed neck metastases during observation after treatment of the primary tumor. METHODS: A retrospective chart review of 47 patients undergoing neck dissection for regional failure after surgical treatment of the primary tumor and observation of the neck from 1987 to 1992 was performed. The median time to failure in the neck was 13 months. RESULTS: The clinical neck stage at the time of neck dissection was N 1 in 37, N(2A) in 6, N(2B) in 1, and N 3 in 3. However, pathologic staging revealed stages of N 1 in 19, N(2A) in 5, N(2B) in 20, and N 3 in 3. Extracapsular spread (ECS) was present in 23 patients (49%). Overall 36 patients (77%) had adverse pathologic findings (N greater than 1 or ECS). CONCLUSIONS: These data indicate that when observation is used for the neck at risk for metastasis, patients tend to fail with high stage disease in the neck. This supports the philosophy of elective treatment of the neck but cannot show whether elective treatment will improve survival. |
| Keywords: | adult; cancer survival; clinical article; aged; treatment failure; retrospective studies; neck dissection; squamous cell carcinoma; carcinoma, squamous cell; conference paper; cancer staging; lymph node metastasis; lymphatic metastasis; lymph node excision; algorithms; head and neck cancer; head and neck neoplasms; cervical lymph node; surgical procedures, elective; neck metastasis; humans; human; male; female; priority journal |
| Journal Title | American Journal of Surgery |
| Volume: | 172 |
| Issue: | 6 |
| Conference Dates: | 1996 Jul 28-Aug 1 |
| Conference Location: | Toronto, Canada |
| ISBN: | 0002-9610 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1996-12-01 |
| Start Page: | 689 |
| End Page: | 691 |
| Language: | English |
| DOI: | 10.1016/s0002-9610(96)00290-5 |
| PUBMED: | 8988679 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Conference Paper -- Export Date: 22 November 2017 -- Source: Scopus |
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