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Therapeutic selective neck dissection: a 25-year review.
1Department of Otolaryngology--Head and Neck Surgery, Loyal University Medical Center, Maywood, Illinois, USA. kamil_muzaffar@hotmail.com
The Laryngoscope
|September 16, 2003
Summary
Selective neck dissection with radiation therapy effectively manages metastatic squamous cell carcinoma in the neck. This approach showed comparable recurrence rates and improved disease-free survival versus radical or modified dissections.
Area of Science:
- Oncology
- Head and Neck Surgery
- Cancer Research
Background:
- Squamous cell carcinoma (SCC) frequently metastasizes to cervical lymph nodes.
- Management of metastatic cervical lymph nodes is crucial for head and neck cancer survival.
- Neck dissection techniques vary, impacting patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of selective neck dissection (SND) combined with postoperative radiation therapy (PORT).
- To compare regional control and disease-free survival rates of SND versus radical neck dissection (RND) and modified neck dissection (MND).
- To assess the role of SND in managing SCC metastatic to cervical lymph nodes.
Main Methods:
- Retrospective review of 176 patients with SCC metastatic to cervical lymph nodes.
- Patients underwent SND (n=61), MND (n=54), or RND (n=61).
- All patients received PORT and had a minimum 2-year follow-up (median 4.3 years).
Main Results:
- No significant statistical difference in regional control among the three groups.
- Recurrence rates: 3.3% for SND vs. 5.2% for RND/MND.
- Two-year disease-free survival: 80% for SND vs. 64% for RND/MND.
Conclusions:
- Selective neck dissection combined with postoperative radiation therapy is effective for managing SCC metastatic to the neck.
- SND offers comparable regional control to RND/MND with potentially better disease-free survival.
- SND represents a viable and potentially advantageous surgical option for selected patients.