Monika E Freiser1, Rosemary B Ojo2, Kaming Lo3, Sandra Saint-Victor4, Craig Bollig5, Chetan S Nayak6, Zoukaa B Sargi7. 1. Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 650D, Miami, FL. Electronic address: freiserme@upmc.edu. 2. Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 650D, Miami, FL. Electronic address: rojo@earsinus.com. 3. Biostatistics Collaboration and Consulting Core, Division of Biostatistics, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 N.W. 14th Street, Suite 1049, Miami, FL. Electronic address: Klo@biostat.med.miami.edu. 4. Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 650D, Miami, FL. Electronic address: Sandra.saintvictor@jhsmiami.org. 5. Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 650D, Miami, FL. Electronic address: bolligc@health.missouri.edu. 6. Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 650D, Miami, FL. Electronic address: CNayak@med.miami.edu. 7. Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 650D, Miami, FL. Electronic address: zsargi@med.miami.edu.
Abstract
PURPOSE: To investigate the difference in survival and complication outcomes between patients with a clinically and radiologically N0 neck who received an elective neck dissection at the time of salvage total laryngectomy compared to those who had salvage total laryngectomy alone. MATERIALS AND METHODS: A retrospective chart review was performed on 125 salvage total laryngectomy patients who were clinically and radiologically N0 preoperatively. Performance of an elective neck dissection and other factors were tested for associations with various postoperative complications, disease-free survival, and overall survival. RESULTS: Ninety-eight patients underwent elective neck dissection, of which ten had positive nodal pathology. Elective neck dissection was not significantly associated with complications or survival outcomes. Positive nodal disease was associated with worse disease-free and overall survival on multivariate analysis. CONCLUSIONS: In patients with clinically and radiologically N0 necks undergoing salvage total laryngectomy, an elective neck dissection can provide prognostic information but does not appear to be significantly associated with increased complications or improved survival.
PURPOSE: To investigate the difference in survival and complication outcomes between patients with a clinically and radiologically N0 neck who received an elective neck dissection at the time of salvage total laryngectomy compared to those who had salvage total laryngectomy alone. MATERIALS AND METHODS: A retrospective chart review was performed on 125 salvage total laryngectomy patients who were clinically and radiologically N0 preoperatively. Performance of an elective neck dissection and other factors were tested for associations with various postoperative complications, disease-free survival, and overall survival. RESULTS: Ninety-eight patients underwent elective neck dissection, of which ten had positive nodal pathology. Elective neck dissection was not significantly associated with complications or survival outcomes. Positive nodal disease was associated with worse disease-free and overall survival on multivariate analysis. CONCLUSIONS: In patients with clinically and radiologically N0 necks undergoing salvage total laryngectomy, an elective neck dissection can provide prognostic information but does not appear to be significantly associated with increased complications or improved survival.
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