title: Effectiveness of therapeutic (N1, N2) selective neck dissection (levels II to V) in patients with laryngeal and hypopharyngeal squamous cell carcinoma.
abstract: BACKGROUND
  The use of selective neck dissection (SND) in the treatment of clinically node-positive necks remains controversial.
  
  
  METHODS
  A total of 48 patients with laryngeal and hypopharyngeal carcinoma underwent 53 primary, therapeutic SNDs (levels II-V) and were retrospectively evaluated.
  
  
  RESULTS
  Regional metastases were staged as pN1 in 8 patients, pN2a in 3, pN2b in 29, and pN2c in 8. Of the primarily treated necks 45 of 53 (85%) were irradiated postoperatively. Extracapsular spread was found in 27 neck specimens (51%). Regional recurrences in level I occurred in one patient (1.8%) and in level II-V in 5 patients (9.4%). The actuarial overall survival at 4 years was 36.5%.
  
  
  CONCLUSIONS
  In selected cases therapeutic SND (levels II-V) in node positive (N1,2) patients with laryngeal or hypopharyngeal carcinoma does not lead to increased risk for recurrence in level I or other levels of the neck and is therefore a safe procedure.
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. p.lohuis@nki.nl
authors.forename: Peter J F M
authors.initials: PJ
authors.lastname: Lohuis
authors.forename: W Martin C
authors.initials: WM
authors.lastname: Klop
authors.forename: I Bing
authors.initials: IB
authors.lastname: Tan
authors.forename: Michiel W M
authors.initials: MW
authors.lastname: van Den Brekel
authors.forename: Frans J M
authors.initials: FJ
authors.lastname: Hilgers
authors.forename: Alfons J M
authors.initials: AJ
authors.lastname: Balm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome