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Second radical neck dissection.

S R Jackson1, P M Stell

  • 1Department of Otorhinolaryngology, University of Liverpool, UK.

Clinical Otolaryngology and Allied Sciences
|February 1, 1991
PubMed
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A second radical neck dissection is performed for recurrent head and neck squamous cell carcinoma. Factors like initial node status and tumor differentiation impact the need for this procedure, with a 35% 5-year survival rate.

Area of Science:

  • Oncology
  • Head and Neck Surgery
  • Cancer Research

Background:

  • Recurrence of head and neck squamous cell carcinoma (HNSCC) in cervical nodes necessitates further treatment.
  • Radical neck dissection is a primary surgical intervention for HNSCC.
  • Contralateral cervical node metastasis after initial treatment poses a significant clinical challenge.

Purpose of the Study:

  • To analyze the incidence and outcomes of a second radical neck dissection in patients with HNSCC.
  • To identify factors predicting the need for a second neck dissection.
  • To determine prognostic indicators for survival following a second neck dissection.

Main Methods:

  • Retrospective analysis of 96 patients undergoing a second radical neck dissection.
  • Evaluation of patient demographics, primary tumor characteristics, and nodal status.

Related Experiment Videos

  • Assessment of survival rates and perioperative mortality.

    • Main Results:

    • The incidence of second neck dissection varied by primary tumor site (0% to 5%).
    • Enlarged initial cervical nodes (5x likelihood) and poorly differentiated tumors (2x likelihood) increased the need for a second dissection.
    • The 5-year survival rate after second neck dissection was 35%, with perioperative mortality at 1.92%.

    Conclusions:

    • The need for a second radical neck dissection in HNSCC is influenced by initial nodal status and tumor differentiation.
    • Time to recurrence, nodal status at recurrence, number of invaded nodes, and extranodal disease are critical for predicting survival.
    • Second radical neck dissection offers a survival benefit in selected HNSCC patients, albeit with associated risks.