The role of neck dissection following definitive chemoradiation.

The presence of regional nodal metastases represents a significant adverse prognostic factor for patients with squamous cell carcinoma of the head and neck. Early-stage head and neck cancers, localized to the primary site without regional lymph node metastases have excellent cure rates with either surgery or radiation therapy. The presence of regional metastases results in cure rates that are approximately half of those obtainable in early-stage disease. Therefore, due to the significant adverse impact of neck metastases on prognosis, the treatment of the neck remains a vital part of the decision-making process in determining therapy for head and neck cancer.