[Efficacy of selective neck dissection: a review of 123 cases of elective and therapeutic treatment of the neck in squamous cell carcinoma of head and neck].
OBJECTIVE
To evaluate the efficacy of selective neck dissection (SND) in elective and therapeutic treatment of the neck in squamous cell carcinoma of head and neck.


METHODS
A retrospective review was undertaken of 123 patients undergoing 157 SNDs as a part of initial therapy for squamous cell carcinoma of head and neck from January 1997 to September 2001 at this institute. The primary site included larynx(n = 77), oral cavity(n = 29), oropharynx(n = 2), and hypopharynx(n = 15). Lymph nodes were pathologically negative (pN0) in 99 and positive (pN+) in 24 patients. Peri-operative radiotherapy was given to 30.3% of pN0 and 50.0% of pN+ patients. The median follow-up interval was 25 months.


RESULTS
101 patients received elective neck dissection, 14 of them (13.9%) found to be pN+, while 22 patients received therapeutic neck dissection, 10 of them (45.5%) found to be pN+. A total of 52 positive nodes were found in 157 SNDs. The distribution of the positive nodes were as follows: Level I 25%; Level II 48%; Level III 25%; Level IV 2%. The 5-year regional recurrence rates estimated according to Kaplan-Meier were 5.87% (95% CI: 0.8%, 10.9%) for the pN0 and 9.2% (95% CI: 0.0%, 21.5%) for pN+ patients.


CONCLUSIONS
The SND, when carefully indicated, a contribution to the concept of less invasive surgery, offers functional and esthetic advantages without oncologic compromise.
Zhang
Bin
B
Head and Neck Surgery, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China. docbinzhang@hotmail.com
Xu
Zhen-gang
ZG
Qi
Yong-fa
YF
Wang
Xiao-lei
XL
Tang
Ping-zhang
PZ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome