Radical neck dissection in nasopharyngeal carcinoma.
We report a series of 37 patients who had radical neck dissection for residual or recurrent lymph node metastasis from nasopharyngeal carcinoma after radiotherapy. The operation was performed despite high doses of pre-operative radiotherapy. There was no operative mortality and the morbidity was 13% (2 prolonged chylous drainage, 3 sloughing of neck flap). The risk of sloughing of neck flap was significantly related to previous lymph node biopsy, which should be avoided if at all possible. In 35% of patients, the lymph node was densely adherent to neighbouring structures. In the 28 patients who had single lymph node clinically, 29% had multiple neck node involvement noted during operation; another 14% were documented only on histological examination. Radical neck dissection rather than excision alone is justified for the clinically solitary lymph node.
Ho
C M
CM
Department of Surgery, Queen Mary Hospital, Hong Kong.
Wei
W I
WI
Sham
J S
JS
Lau
S K
SK
Lam
K H
KH
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000532:radiotherapy / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011183:Postoperative Complications