Effectiveness of therapeutic (N1, N2) selective neck dissection (levels II to V) in patients with laryngeal and hypopharyngeal squamous cell carcinoma.
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.
Lohuis
Peter J F M
PJ
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
Klop
W Martin C
WM
Tan
I Bing
IB
van Den Brekel
Michiel W M
MW
Hilgers
Frans J M
FJ
Balm
Alfons J M
AJ
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