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Synchronous bilateral neck dissection

A J Ballantyne, G L Jackson

    American Journal of Surgery
    |October 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Synchronous bilateral radical neck dissection is a viable treatment for metastatic cervical cancer when lymph nodes are positive on both sides. This procedure, when performed carefully, offers a reasonable prospect for cure with manageable complications.

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    Area of Science:

    • Oncology
    • Surgical Oncology
    • Head and Neck Cancer

    Background:

    • Treatment for metastatic cancer in the cervical region, particularly with bilateral lymph node involvement, is debated.
    • Bilateral neck dissection is mandatory for clinically positive lymph nodes on both sides of the neck.
    • Synchronous bilateral radical neck dissection (SBRND) has historically been associated with significant morbidity.

    Purpose of the Study:

    • To report the indications, complications, and outcomes of 179 synchronous bilateral neck dissections.
    • To evaluate the safety and efficacy of SBRND in managing bilateral cervical lymph node metastasis.
    • To analyze factors influencing recurrence and cure rates in patients undergoing SBRND.

    Main Methods:

    • Retrospective review of 179 patients who underwent synchronous bilateral radical neck dissection between 1967 and 1979.

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  • Surgical technique focused on preserving the internal jugular vein on at least one side in most cases.
  • Analysis of patient data including indications, operative complications, mortality, and recurrence rates.

    • Main Results:

    • The overall mortality rate for SBRND was 3.4%.
    • The internal jugular vein was preserved on one or both sides in all but one patient.
    • Patients with histologically positive lymph nodes bilaterally demonstrated a reasonable prospect for cure.

    Conclusions:

    • Synchronous bilateral radical neck dissection can be performed with acceptable morbidity and mortality when indicated for bilateral cervical lymph node metastasis.
    • Preservation of the internal jugular vein is feasible and likely contributes to reduced complications.
    • Cancer recurrence is more often linked to primary tumor control failure than to neck dissection treatment failure.