title: Survival of patients with neck recurrence following radical neck dissection: utility of a second neck dissection?
abstract: Treatment of neck recurrence following radical neck dissection is extremely difficult. Retrospective review of 699 radical neck dissections was performed. Recurrence rates, host, tumor, treatment factors, and survival were analyzed. One hundred nineteen patients who had undergone radical neck dissections had recurrence, 69 were considered candidates for salvage surgery. Factors that increased the risk of neck recurrence were neck node (N) status and no adjuvant radiotherapy. Factors associated with radical salvage treatment were young age, good general condition, and low recurrent N classification. Five-year survival for salvage neck dissection was 31%. Young patients and low T and N classification did well. Low recurrent N classification and salvage surgery were associated with good prognosis for recurrence. In our study, radical neck dissection has a regional failure rate of 20%, a third of recurrence cases were offered curative treatment. Of these, 31% were cured with salvage surgery.
authors.affiliation: School of Cancer Studies, Division of Surgery and Oncology, University of Liverpool, Liverpool, United Kingdom. profasjones@beestoncastle.fsnet.co.uk
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Jones
authors.forename: Sankalap
authors.initials: S
authors.lastname: Tandon
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Helliwell
authors.forename: David J
authors.initials: DJ
authors.lastname: Husband
authors.forename: Terence M
authors.initials: TM
authors.lastname: Jones
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy / Q000379:methods*; D016019:Survival Analysis