Bilateral radical neck dissection: results in 193 cases

Area of Science:

• Surgical Oncology
• Head and Neck Surgery
• Cancer Metastasis Research

Background:

• The necessity of simultaneous bilateral radical neck dissection for head and neck cancers is debated.
• Assessing its outcomes, including complications, metastatic patterns, recurrence, and survival, is crucial.

Purpose of the Study:

• To evaluate the frequency of postoperative complications following simultaneous bilateral radical neck dissection.
• To analyze patterns of lymph node metastasis in surgical specimens.
• To identify predictors of neck recurrence and prognostic factors for overall survival.

Main Methods:

• Retrospective analysis of 193 patients undergoing simultaneous bilateral radical neck dissection between 1960 and 1990.
• Review of postoperative complications, lymph node involvement, recurrence rates, and survival data.

Main Results:

• High complication rate (60.8%), including fistula, infection, and flap issues; 2.7% postoperative mortality.
• Upper jugular and accessory lymph node groups were most frequently involved.
• Predictors of recurrence included age, N stage, and metastasis at specific neck levels (ipsilateral II, contralateral II/IV).
• 5-year survival significantly lower for older patients (>40) and those with advanced lymph node metastasis (N3/Nx).
• Contralateral metastatic lymph nodes and age were independent predictors of mortality.

Conclusions:

• Simultaneous bilateral radical neck dissection is associated with significant morbidity and should not be performed electively.
• Further research into selective neck dissection techniques is recommended for improved patient outcomes.