Related Experiment Video
Updated: Aug 2, 2026
Murine Mesenteric Lymphadenectomy for Selective Disruption of Lymphatic Communication with Region-Specific Gut
Published on: December 30, 2025
[Selective neck dissection in the treatment of pN1/2 lymph node metastases in the neck]
Rajko Jović1, Karol Canji, Slobodan Mitrović
1Klinika za bolesti uva, grla i nosa, Klinicki centar Novi Sad. rajkojov@eunet.yu
Introduction:
As yet there is no single reliable and accurate method for detection of neck lymph node metastases. Therapeutic approaches differ from one author to other. The aim of this paper was to establish the extent to which, with good control of primary process, we can control spreading of malignant disease by means of selective neck dissection.
Material And Method:
This retrospective study included 595 surgically treated patients in the period 1990-1998. There were 525 patients with malignant laryngeal tumors, and 70 patients with malignant hypopharyngeal tumors. Preoperative diagnostics of enlarged lymph nodes was based on palpation of the neck, without CT, US, NMR diagnostics. With all risky N0 patients, selective neck dissection was performed for presence of occult metastases. Intraoperative frozen section analysis was not performed. Adjuvant radiatitherapy was performed in all patients in whom presence of neck lymph node metastases was histologically proved.
Results:
Selective lateral neck dissection was performed in 389 (65.4%) patients. In 78 (20%) patients, lymph node metastases were pathohistologically detected. In 5 (6.4%) transitional cellular cancer was histologically diagnosed, and the remaining 73 (93.6%) presented with squamous cell cancer. Postoperative radiation therapy was applied in 54 patients (69.2%) while 24 (30.8%) were not irradiated. 5-year survival was achieved in 18 (23.1%), and 3-year survival was achieved in 15 (19.2%) patients. Out of 45 patients who lived less than tree year, 18 (40%) presented with metastatic relapse and fatal outcome. Relapse of neck metastases appeared in 12 (11.9%) on the side and in the zones of lymph nodes which were included in neck dissection. Recurrence of neck metastases appeared in 8.3% of patients who were not irradiated postoperatively and in 32.1% of cases irradiated postoperatively.
Discussion:
This study includes comparison of our results with results of literature data.
Conclusion:
Neck lymph node metastases point to advanced malignant process of the third or forth stage of the disease when results are the worst and 5-year survival decreases with or without adjuvant radiotherapy.
Insights
Selective neck dissection is a crucial surgical procedure for controlling malignant disease spread. While it can detect metastases, advanced stages significantly reduce survival rates, even with radiotherapy.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Cancer Research
Context:
- Accurate detection of neck lymph node metastases remains a challenge in cancer treatment.
- Therapeutic strategies for managing malignant disease vary among clinicians.
- Selective neck dissection is explored as a method to control cancer spread.
Purpose:
- To evaluate the effectiveness of selective neck dissection in controlling the spread of malignant disease.
- To assess the impact of neck lymph node metastases on patient survival.
- To compare outcomes with existing literature data.
Summary:
- A retrospective study analyzed 595 patients with laryngeal or hypopharyngeal tumors treated between 1990-1998.
- Selective neck dissection was performed on 389 patients, with metastases detected in 20%.
- Survival rates were lower in advanced stages, with radiotherapy showing varied effects on recurrence.
Impact:
- Findings suggest that neck lymph node metastases indicate advanced disease, negatively impacting survival.
- The study highlights the limitations of current diagnostic methods and treatment approaches.
- Results provide insights into the prognostic significance of lymph node involvement in head and neck cancers.
