Selective neck dissection for treating node-positive necks in cases of squamous cell carcinoma of the upper aerodigestive tract.
OBJECTIVE
Modified radical neck dissection (MRND) is the classical treatment for neck metastases of squamous cell carcinoma (SCC) of the upper aerodigestive tract. However, it may still be accompanied by significant sequelae. One alternative for this treatment would be selective neck dissection (SND), which has a lower incidence of sequelae. The aim of this study was to define which neck metastasis cases would really be suitable candidates for SND.


METHODS
Retrospective clinical-surgical trial at the Division of Head and Neck Surgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP).


METHODS
We retrospectively studied 67 patients with SCC of the upper aerodigestive tract, divided into two groups: 1) 47 patients treated by means of SND (node-negative or node-positive), 2) 20 patients treated by means of MRND (all node-positive).


RESULTS
Our results demonstrated that there was no difference between the patients treated with SND or MRND in relation to disease evolution, and that the main prognostic factor was lymph node involvement. We observed that patients with pharyngeal SCC and older patients presented worse evolution and would probably not be suitable candidates for SND.


CONCLUSIONS
SND may be a good option for treating node-positive necks in selected cases.
Division of Head and Neck Surgery, Department of Surgery, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, Brazil.
Jamile Karina
JK
Antonio
Marcelo Benedito
MB
Menezes
Norberto Kodi
NK
Kavabata
Antonio Augusto Tupinambá
AA
Bertelli
William
W
Kikuchi
Antonio José
AJ
Gonçalves
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D010039:Otorhinolaryngologic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome