Complications from planned, posttreatment neck dissections.
OBJECTIVE
To report the complication rate from planned, posttreatment neck dissections in patients who show control of primary squamous cell carcinoma by chemotherapy and radiotherapy or radiotherapy alone.


METHODS
Retrospective review of case series.


METHODS
Georgetown University Medical Center, Washington, DC.


METHODS
Thirty-four patients with clinically positive neck disease treated with organ preservation therapy for squamous cell carcinoma of the head and neck.


METHODS
Planned neck dissection after treatment with chemotherapy and radiotherapy or radiotherapy alone.


METHODS
Perioperative complications.


RESULTS
Forty-one neck dissections were performed on 34 patients. Complications were seen in 13 (38%) of 34 patients and 15 (37%) of 41 neck dissections. Wound complications occurred in 9 (22%) of 41 dissections. Neck dissection complication rate did not correlate with previous use of chemotherapy or with the use of brachytherapy at the primary site at the time of the neck dissection. Preoperative radiotherapy dose greater than 70 Gy was associated with complications in 58% vs 29% when preoperative dose was less than 70 Gy (P = .09). This trend was reflected primarily in wound complications (42% vs 14%; P = . 10) and reached significance for skin flap necrosis (33% vs 0%; P = .005). Other factors that were associated with increased complications were preoperative albumin level less than 38 g/L and early neck drain removal.


CONCLUSIONS
The complication rate associated with planned posttreatment neck dissection is similar to that previously reported for neck dissection. Wound complications are more common when higher preoperative radiotherapy doses are used.
Davidson
B J
BJ
Department of Otolaryngology-Head and Neck Surgery, Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA. davidsob@gunet.georgetown.edu
Newkirk
K A
KA
Harter
K W
KW
Picken
C A
CA
Cullen
K J
KJ
Sessions
R B
RB
D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008197:Lymph Node Excision; D009333:Neck; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D014062:Tongue Neoplasms / Q000473:pathology / Q000601:surgery