[Efficacy of radical neck dissection for advanced cervical nodal metastases].
OBJECTIVE
To investigate the efficacy of radical neck dissection (RND) to control advanced cervical nodal metastases and analyze the risk factors related with cervical recurrence in head and neck cancer.


METHODS
One hundred and twelve patients with N2, N3 head and neck cancer were treated by RND were retrospectively reviewed and the pathological specimen were restudied.


RESULTS
Five-year cervical recurrence rate of patients with advanced nodal metastases after RND is 27.7% (31/112), and 16.5% (13/79), 54.5% (18/33) in N2, N3 respectively. The overall 3-year, 5-year survival rate of patients with cervical recurrence after RND was 16.1% (5/31), 9.7% (3/31) respectively. In a univariate chi2 analysis, it was confirmed that the following variables correlated to cervical recurrence, i. e., clinical N staging, size of positive neck nodes, presence of extracapsular nodal spread and invasion of nonlymphatic structures. In a multivariate logistic regression analysis, the most significant risk factor for cervical recurrence was the size of positive neck nodes.


CONCLUSIONS
Cervical recurrence is one of the most common reasons for tumor recurrence of head and neck cancer. The size of positive neck nodes is the key risk factor in determining the development of cervical recurrence in patients of advanced cervical nodal metastases after RND. Patients with presence of extracapsular nodal spread and invasion of nonlymphatic structures have high risk of developing cervical recurrence.
Di
Bin
B
Department of Otorhinolaryngology Head & Neck Surgery, People's Liberation Army Center for Otolaryngological Diseases, Bethune International Peace Hospital, Shijiazhuang 050082, China.
Li
Xiao-Ming
XM
Shao
Yong-Liang
YL
He
Zhan-Gguo
ZG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome