Related Experiment Video
Updated: Jun 6, 2026
Modified Radical Neck Dissection for Cervical Metastasis
Published on: February 20, 2026
Number needed to treat analysis for planned neck dissection after chemoradiotherapy for advanced neck disease
Hedyeh Javidnia1, Martin J Corsten
1Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, ON. hedyeh2@yahoo.com
Objective:
to analyze how many planned neck dissections (PNDs) must be performed to prevent one fatal neck recurrence after chemoradiotherapy for head and neck cancer with regional metastasis.
Methods:
a systematic literature review of studies using chemoradiotherapy as primary treatment for head and neck cancer was performed. Data were extracted where possible to determine estimates for the following variables: (1) percentage of N2-3 necks still harbouring cancer after chemoradiotherapy as proven by pathology from neck dissection (C); (2) percentage of regional recurrence after PND (P); (3) percentage of regional recurrence after salvage neck dissection for patients without initial PND in whom neck disease recurred after chemoradiotherapy (S); and (4) mortality rate of PND (M). The number needed to treat was calculated using the following equation: NNT = 1/[C*(S+M) - (P+M)].
Results:
the number needed to treat is 7.5.
Conclusion:
to prevent one fatal neck recurrence after chemoradiotherapy for head and neck cancer with N2-3 disease, one would need to perform 7.5 PNDs. The results of this study will aid surgeons and patients in making more informed decisions regarding neck dissections.
