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.
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 patientdeath. 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.
Authors: K Thomas Robbins; Alfio Ferlito; Jatin P Shah; Marc Hamoir; Robert P Takes; Primož Strojan; Avi Khafif; Carl E Silver; Alessandra Rinaldo; Jesus E Medina Journal: Eur Arch Otorhinolaryngol Date: 2012-08-19 Impact factor: 2.503
Authors: Babak Givi; Gary Linkov; Ian Ganly; Snehal G Patel; Richard J Wong; Bhuvanesh Singh; Jay O Boyle; Ashok R Shaha; Jatin P Shah; Dennis H Kraus Journal: Otolaryngol Head Neck Surg Date: 2012-04-18 Impact factor: 3.497
Authors: H Hakan Coskun; Jesus E Medina; K Thomas Robbins; Carl E Silver; Primož Strojan; Afshin Teymoortash; Phillip K Pellitteri; Juan P Rodrigo; Sandro J Stoeckli; Ashok R Shaha; Carlos Suárez; Dana M Hartl; Remco de Bree; Robert P Takes; Marc Hamoir; Karen T Pitman; Alessandra Rinaldo; Alfio Ferlito Journal: Head Neck Date: 2014-06-30 Impact factor: 3.147