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Extended neck dissection

J F Carew¹, R H Spiro

¹Department of Otolaryngology-Head and Neck Surgery, Manhattan Eye, Ear and Throat Hospital, New York, New York, USA.

American Journal of Surgery

|November 28, 1997

Summary

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Extended radical neck dissection (ERND) offers a chance for neck disease control and survival in advanced head and neck cancer cases. Multimodality therapy improved outcomes for patients undergoing ERND.

Area of Science:

Head and Neck Oncology
Surgical Oncology
Cancer Research

Background:

Extended radical neck dissection (ERND) is a surgical procedure for advanced head and neck cancers.
Understanding the specific clinical scenarios and outcomes of ERND is crucial for treatment planning.

Purpose of the Study:

To define the clinical settings for ERND.
To evaluate the impact of ERND on neck disease control.
To assess the effect of ERND on patient survival.

Main Methods:

Retrospective review of 106 patients who underwent ERND between 1984 and 1993.
Focus on patients with metastatic squamous cell carcinoma (SCC) with extranodal extension.

Main Results:

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Five-year disease-free survival was 39%; neck disease control was achieved in 68% of patients.

Patients with SCC showed a trend toward better survival (47%) compared to other histologies (24%).

Involvement of upper neck levels (I-III) correlated with better survival (46%) than lower/multiple levels (14%). Postoperative radiation improved survival (47% vs. 22%).

Conclusions:

Advanced neck disease with extranodal invasion is a poor prognostic sign.
Multimodality therapy, including ERND, can achieve significant neck control and 5-year survival in nearly half of selected patients.
Optimizing treatment strategies, including the role of radiation, is key for improving outcomes in advanced head and neck cancer.