Selective neck dissection for neck residue of nasopharyngeal carcinoma: A prospective study

Cervical residue or recurrence of nasopharyngeal carcinoma (NPC) is traditionally treated with radical neck dissection (RND). Because cervical residue patients with NPC exhibit better prognoses than patients with neck recurrence, selective neck dissection (SND) rather than RND may be the optimal treatment for these patients. This study was designed to evaluate the efficacy of SND for the management of neck residue of NPC.

Between January 2008 and July 2013, a total of 69 patients were assigned to undergo either RND or SND in the Department of Head and Neck Surgery at Fudan University Cancer Center. The patients' clinical and pathological characteristics, complications, and treatment outcomes were evaluated and analyzed.

Our study consisted of 69 patients, including 51 in the RND group and 18 in the SND group. There was no significant difference in any clinical or pathological characteristic between the two groups. The overall survival (OS), disease-free survival (DFS), and regional-free survival of all the patients were 79.70%, 61.43%, and 83.30%, respectively, at 3 years and 66.81%, 47.43%, and 78.67%, respectively, at 5 years. No statistically significant difference was found in the OS, DFS, or regional-free survival between the RND and SND groups. The total complication rate was much lower in the SND group (11.11%) than in the RND group. The patients in the RND group experienced longer hospitalization and postoperative hospitalization than those in the SND group.

SND was demonstrated to be safe and effective for the treatment of neck residue of NPC. The results indicated that patients with neck residue disease who are at stage II to III with a single enlarged lymph node (<1 cm) and only one positive pathological lymph node may benefit the most from SND.