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Related Experiment Videos

Efficacy of selective lymph node dissection in clinically negative neck.

Eugenio Mira1, Marco Benazzo, Vanessa Rossi

  • 1Department of Otorhinolaryngology, University of Pavia, and IRCCS Policlinico S Matteo, Italy. e.mira@smatteo.pv.it

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|October 29, 2002
PubMed
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Selective neck dissection (SND) is effective for treating the clinically negative neck in head and neck squamous cell carcinoma (SCC). This approach matches comprehensive procedures for staging and treatment, showing comparable recurrence rates.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Head and Neck Surgery

Background:

  • Head and neck squamous cell carcinoma (SCC) management requires accurate staging of the neck.
  • The clinically negative neck (N0) presents a challenge in determining the need for treatment.
  • Selective neck dissection (SND) is an alternative to comprehensive neck dissection.

Purpose of the Study:

  • To evaluate the efficacy of selective neck dissection (SND) for the elective treatment of the clinically negative neck in patients with head and neck squamous cell carcinoma (SCC).

Main Methods:

  • A retrospective review of 91 previously untreated patients with T1-4 SCC and clinically negative necks (N0).
  • 126 SND procedures were performed between January 1990 and March 1999.
  • Postoperative radiation therapy was administered to 25 patients based on specific high-risk pathologic findings.

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Main Results:

  • Occult disease was detected in 11.11% of dissected necks, with 42.85% of positive nodes showing extracapsular spread (ECS).
  • The overall recurrence rate was 12.8%, with only one recurrence outside the dissected field.
  • Overall survival was 84%, with a significant difference noted between pathologically node-negative (pN0) and node-positive (pN+) patients.

Conclusions:

  • Selective neck dissection (SND) is a pragmatic and effective method for staging and treating the clinically negative neck in head and neck SCC.
  • SND demonstrates comparable efficacy to more comprehensive neck procedures for the N0 neck.
  • The study supports SND as a valuable approach in the management of early-stage head and neck cancers.