Efficacy of Selective Neck Dissection: A Review of 503 Cases of Elective and Therapeutic Treatment of the Neck in Squamous Cell Carcinoma of the Upper Aerodigestive Tract

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  • Petra Ambrosch
    Department of Otorhinolaryngology‐Head and Neck Surgery University of Goettingen Goettingen Germany
  • Martina Kron
    Department of Biometry and Medical Documentation University of Ulm Ulm Germany
  • O. Pradier
    Department of Radiation Oncology University of Goettingen Goettingen Germany
  • W. Steiner
    Department of Otorhinolaryngology‐Head and Neck Surgery University of Goettingen Goettingen Germany

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<jats:sec><jats:title>OBJECTIVE</jats:title><jats:p>The purpose of this study was to evaluate the efficacy of selective neck dissection (SND) in elective and therapeutic treatment of the neck.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>A retrospective review was undertaken of 503 previously untreated patients undergoing 711 SNDs as a part of initial therapy for squamous cell carcinoma of the larynx, oral cavity, oropharynx, and hypopharynx from August 1986 to June 1997 at a single institution. Lymph nodes were pathologically negative in 249 and positive in 254 patients. Postoperative radiotherapy was given to 14.5% of the node‐negative and 62.2% of the node‐positive patients. The median follow‐up interval was 41 months.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>The 3‐year regional recurrence rates estimated according to Kaplan‐Meier were as follows: pN0, 4.7%; pN1, 4.9%; pN2, 12.1%. A comparison of recurrence rates with respect to the extent of neck disease and postoperative radiotherapy demonstrated a tendency to an improved regional control in irradiated patients with one metastasis and a distinctly improved regional control in patients with multiple metastases or metastases with extracapsular spread.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSION</jats:title><jats:p>The results achieved with SND compare favorably with the results reported for modified radical neck dissection. The application of SND might be extended to more advanced neck disease.</jats:p></jats:sec>

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