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Karen T. Pitman, MD; Jonas T. Johnson, MD; Eugene N. Myers, MD

Arch Otolaryngol Head Neck Surg. 1997;123(9):917-922.

Abstract
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.

Arch Otolaryngol Head Neck Surg. 1997;123:917-922

Author Affiliations
From the Department of Otolaryngology, School of Medicine, University of Pittsburgh, Pittsburgh, Pa. Dr Pitman is now with the Department of Otolaryngology, Naval Medical Center, Portsmouth, Va.

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