This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (27)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Oncology  • Head & Neck Cancer  • Neoplasms of Head & Neck  • Surgical Oncology  • Alert me on articles by topic  Social Bookmarking   What's this?

Peter E. Andersen, MD; Frank Warren, MD; Jeffrey Spiro, MD; Alan Burningham, MD; Richard Wong, MD; Mark K. Wax, MD; Jatin P. Shah, MD; James I. Cohen, MD, PhD

Arch Otolaryngol Head Neck Surg. 2002;128:1180-1184.

Background  Although increasingly accepted in treatment of the N0 neck, use of selective neck dissection in patients with node-positive squamous cell carcinoma of the head and neck remains controversial.

Objective  To determine the oncologic efficacy of selective node dissection in patients with node-positive squamous carcinoma of the head and neck.

Setting  Three tertiary care academic/Veterans Affairs medical centers.

Methods  Ten-year retrospective medical chart review of 106 previously untreated clinically and pathologically node-positive patients undergoing 129 selective neck dissections and followed for a minimum of 2 years or until patient death.

Results  Regional metastasis was clinically staged as N1 in 58 patients (54.7%), N2a in 5 (4.7%), N2b in 28 (26.4%), N2c in 14 (13.2%), and N3 in 1 (0.9%). Extracapsular extension of tumor was present in 36 patients (34.0%), and postoperative radiation therapy was administered to 76 patients (71.7%). Overall, 9 patients experienced disease recurrence in the neck. Six of these recurrences were in the side of the neck that had undergone selective neck dissection, for a regional control rate of 94.3%.

Conclusions  These results support the use of selective neck dissection in carefully selected patients with clinically node-positive squamous cell carcinoma of the head and neck region. Regional control rates comparable to those achieved with comprehensive operations can be achieved in appropriately selected patients.

From the Department of Otolaryngology/Head and Neck Surgery, Oregon Health Sciences University, Portland (Drs Andersen, Warren, Burningham, Wax, and Cohen); University of Connecticut Health Center, Farmington (Dr Spiro); and the Memorial Sloan-Kettering Cancer Center, New York, NY (Drs Wong and Shah).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Metastatic Neck Disease Beyond the Limits of a Neck Dissection: Attention to the 'Para-hyoid' Area in T1/2 Oral Tongue Cancer
Ando et al.
Jpn J Clin Oncol 2009;39:231-236.
ABSTRACT | FULL TEXT  

Selective Neck Dissection for Node-Positive Necks in Patients With Head and Neck Squamous Cell Carcinoma: A Word of Caution
Santos et al.
Arch Otolaryngol Head Neck Surg 2006;132:79-81.
ABSTRACT | FULL TEXT  

Selective vs Modified Radical Neck Dissection and Postoperative Radiotherapy vs Observation in the Treatment of Squamous Cell Carcinoma of the Oral Tongue
Schiff et al.
Arch Otolaryngol Head Neck Surg 2005;131:874-878.
ABSTRACT | FULL TEXT  

Long-term Results of 100 Consecutive Comprehensive Neck Dissections: Implications for Selective Neck Dissections
Sivanandan et al.
Arch Otolaryngol Head Neck Surg 2004;130:1369-1373.
ABSTRACT | FULL TEXT  

Is Selective Neck Dissection Adequate Treatment for Node-Positive Disease?
Gourin
Arch Otolaryngol Head Neck Surg 2004;130:1431-1434.
FULL TEXT