Is selective neck dissection sufficient treatment for the N0/Np+ neck?
OBJECTIVE
The purpose of this study was to evaluate the therapeutic role of selective neck dissection performed electively in the N0 patient.


METHODS
Fifty-four patients with squamous cell carcinoma of the oral cavity, pharynx, and larynx, without clinical evidence of lymph node metastases, underwent 72 selective neck dissections over a 6-year period. The preoperative tumour and patient data were recorded in all patients. Mean follow-up was 59 months. Outcome data pertaining to pathologic nodal status, tumour recurrence, and survival were recorded on all patients.


RESULTS
Eighty-one percent of patients were histologically and clinically node negative. Seven percent of N0/Np0 patients failed in the neck compared to 50% of patients with occult nodal metastases (N0/Np+). Salvage treatment following nodal recurrence was successful in only one patient.


CONCLUSIONS
Selective neck dissection does not compromise survival and may minimize surgical morbidity in the N0/Np+ population.
Davidson
J
J
Department of Otolaryngology, University of Toronto, Sunnybrook Health Science Center, Ontario.
Khan
Y
Y
Gilbert
R
R
Birt
B D
BD
Balogh
J
J
MacKenzie
R
R
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome