Clinical experiences with surgical therapy of cervical metastases from head and neck cancer

Indications for the various techniques of neck dissection can undergo substantial variations according to the metastatic picture found, biological aggressiveness of tumor, nodal volume and personal philosophies of the attending clinician. In the present paper we report our clinical experience with radical neck dissections, "functional" neck dissections and selective neck dissections-in total, 1658 neck dissections carried out between 1976 and 1991. We discuss the indications and contra-indications of the various surgical techniques of neck dissection and evaluate the long-term results. Our current preference is to use the Suarez-Bocca "functional" technique of neck dissection for prophylactic treatment of the neck and for therapeutic treatment of the neck when intracapsular metastases already exist.