Selective neck dissection in node-positive squamous cell carcinoma of the head and neck Journal Article
| Authors: | Givi, B.; Linkov, G.; Ganly, I.; Patel, S. G.; Wong, R. J.; Singh, B.; Boyle, J. O.; Shaha, A. R.; Shah, J. P.; Kraus, D. H. |
| Article Title: | Selective neck dissection in node-positive squamous cell carcinoma of the head and neck |
| Abstract: | Objective. The optimal type of neck dissection in head and neck squamous cell carcinoma (SCC) with clinical cervical metastases has not been determined. The following study was performed to determine the rate of regional control with selective neck dissection (SND) in these patients. Study Design. Case series with planned data collection. Setting. Single institution, cancer center. Methods and Subjects. Patients with cervical lymph node metastases from mucosal cancers of the head and neck who were treated with SND from 2000 to 2010 were selected. Demographics, tumor characteristics, extent of neck dissection, adjuvant treatments, locoregional control, and survival were recorded. Recurrence in the neck and disease-specific survival (DSS) were primary and secondary end points. Results. One hundred eight patients underwent SND. Sixtynine (64%) were male. Median age was 62 (20-89) years. The most common primary site was the oral cavity (71.3%). Ninety-five (88%) received adjuvant treatment. Median follow-up was 21 months. Six patients (5.5%) had isolated recurrence in the dissected neck. Patients with N2C disease had poorer neck recurrence-free survival. At the end of study, 64 (59.3%) patients had no evidence of disease, and 23 (21.3%) had died of disease. Two-year DSS was 76.9%. Number of positive nodes (P = .026) and positive surgical margins (P = .001), among others, were predictors of poorer DSS. Conclusion. In a highly selected group of patients with cervical lymph node metastases from head and neck SCC, selective neck dissection is effective in controlling the disease in the neck when performed in the setting of a multimodality treatment, including adjuvant radiotherapy or radiochemotherapy. © 2012 American Academy of Otolaryngology - Head and Neck Surgery Foundation. |
| Keywords: | adult; cancer survival; treatment outcome; aged; aged, 80 and over; middle aged; survival rate; major clinical study; cancer recurrence; neck dissection; carcinoma, squamous cell; multimodality cancer therapy; cancer patient; cancer radiotherapy; chemotherapy, adjuvant; radiotherapy, adjuvant; follow up; lymph node metastasis; lymphatic metastasis; lymph node excision; prospective studies; demography; neoplasm recurrence, local; information processing; cancer center; head and neck cancer; head and neck neoplasms; cervical lymph node; regression analysis; disease specific survival; mouth cancer; chemoradiotherapy; mouth cavity; recurrence free survival; fatality; head and neck squamous cell carcinoma; surgical treatment; survival prediction |
| Journal Title: | Otolaryngology - Head and Neck Surgery |
| Volume: | 147 |
| Issue: | 4 |
| ISSN: | 0194-5998 |
| Publisher: | Sage Publications |
| Date Published: | 2012-10-01 |
| Start Page: | 707 |
| End Page: | 715 |
| Language: | English |
| DOI: | 10.1177/0194599812444852 |
| PROVIDER: | scopus |
| PUBMED: | 22517013 |
| PMCID: | PMC5787853 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 January 2013" - "CODEN: OTOLD" - "Source: Scopus" |
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