Effectiveness of selective neck dissection for management of the clinically negative neck.
OBJECTIVE
To determine the effectiveness of selective neck dissection for management of the clinically negative neck in head and neck squamous cell carcinoma.


METHODS
A retrospective comparison of patients treated electively with selective neck dissection and comprehensive neck dissection.


METHODS
Academic tertiary referral center.


METHODS
Patients with clinically negative necks and previously untreated head and neck squamous cell carcinoma.


METHODS
Elective neck dissection, surgical treatment of the primary lesion, and postoperative radiotherapy as indicated.


METHODS
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.


CONCLUSIONS
Elective neck dissection provides invaluable staging information, which guides the decision for adjuvant therapy.
Pitman
K T
KT
Department of Otolaryngotogy, School of Medicine, University of Pittsburgh, PA, USA.
Johnson
J T
JT
Myers
E N
EN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000931:Antidotes / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003657:Decision Making; D018572:Disease-Free Survival; D017558:Elective Surgical Procedures; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008197:Lymph Node Excision / Q000145:classification; D008198:Lymph Nodes / Q000473:pathology; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection / Q000145:classification; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome
D000931:Antidotes; D000964:Antimetabolites, Antineoplastic; D002955:Leucovorin; D005472:Fluorouracil; D008727:Methotrexate