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Is selective neck dissection sufficient treatment for the N0/Np+ neck?
J Davidson1, Y Khan, R Gilbert
1Department of Otolaryngology, University of Toronto, Sunnybrook Health Science Center, Ontario.
Objective:
The purpose of this study was to evaluate the therapeutic role of selective neck dissection performed electively in the N0 patient.
Method:
Fifty-four patients with squamous cell carcinoma of the oral cavity, pharynx, and larynx, without clinical evidence of lymph node metastases, underwent 72 selective neck dissections over a 6-year period. The preoperative tumour and patient data were recorded in all patients. Mean follow-up was 59 months. Outcome data pertaining to pathologic nodal status, tumour recurrence, and survival were recorded on all patients.
Results:
Eighty-one percent of patients were histologically and clinically node negative. Seven percent of N0/Np0 patients failed in the neck compared to 50% of patients with occult nodal metastases (N0/Np+). Salvage treatment following nodal recurrence was successful in only one patient.
Conclusion:
Selective neck dissection does not compromise survival and may minimize surgical morbidity in the N0/Np+ population.