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Effectiveness of selective neck dissection for management of the clinically negative neck
K T Pitman1, J T Johnson, E N Myers
1Department of Otolaryngotogy, School of Medicine, University of Pittsburgh, PA, USA.
Objective:
To determine the effectiveness of selective neck dissection for management of the clinically negative neck in head and neck squamous cell carcinoma.
Design:
A retrospective comparison of patients treated electively with selective neck dissection and comprehensive neck dissection.
Setting:
Academic tertiary referral center.
Patients:
Patients with clinically negative necks and previously untreated head and neck squamous cell carcinoma.
Intervention:
Elective neck dissection, surgical treatment of the primary lesion, and postoperative radiotherapy as indicated.
Outcome Measures:
Regional recurrence, distant metastasis, and disease-free survival.
Results:
Selective neck dissection was as effective as comprehensive procedures for staging the clinically negative neck. Occult metastases had a statistically significant effect on patient outcome as measured by distant metastasis.
Conclusion:
Elective neck dissection provides invaluable staging information, which guides the decision for adjuvant therapy.