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Selective neck dissection in the management of the clinically node-negative neck
A S Hosal1, R L Carrau, J T Johnson
1Department of Otolaryngology--Head and Neck Surgery, Hacettepe University Medical Faculty, Ankara, Turkey.
The Laryngoscope
|December 29, 2000
Summary
Selective neck dissection (SND) effectively manages the node-negative neck, identifying patients needing adjuvant therapy. This study found low recurrence rates, especially when extracapsular spread is absent.
Area of Science:
- Oncology
- Head and Neck Surgery
- Surgical Pathology
Background:
- The management of the clinically node-negative neck in head and neck cancer requires careful consideration.
- Selective neck dissection (SND) is a surgical technique employed in these cases.
Purpose of the Study:
- To evaluate the efficacy of selective neck dissection (SND) in managing the clinically node-negative neck.
- To assess the oncological outcomes and recurrence rates following SND.
Main Methods:
- Retrospective analysis of case histories.
- Review of 300 neck dissections performed on 210 patients with primary sites including oral cavity, oropharynx, hypopharynx, and larynx.
Main Results:
- 23% of dissected necks were pathologically node-positive.
- Regional recurrence occurred in 4% of patients without extracapsular spread, compared to 18% with extracapsular spread (statistically significant).
- Recurrence rates were comparable between pathologically node-negative and node-positive necks in patients not receiving adjuvant irradiation.
Conclusions:
- Selective neck dissection (SND) is an effective surgical approach for controlling neck disease in clinically node-negative patients.
- SND aids in identifying patients who would benefit from adjuvant therapy, particularly those with extracapsular spread or multiple positive nodes.