Effectiveness of modified radical neck dissection and postoperative radiotherapy.
OBJECTIVE
The aim of this study was to evaluate the effectiveness of a modified radical neck dissection with preservation of non-lymphatic structures usually removed in advanced-stage head and neck epidermoid carcinoma associated with postoperative radiotherapy (PORT).


METHODS
We analyzed retrospectively the files of 109 patients, presenting with epidermoid carcinoma of the upper digestive/respiratory tract staged N2 or N3, over a 6-year period. The rates of regional control, mortality, and recurrence were analyzed and linked to the kind of neck-dissection (usual radical neck dissection [RND], modified radical neck dissection [MRND], selective neck-dissection [SND]) performed.


RESULTS
Forty-three neck dissections were RND, 92 were MRND, and 21 were SND. PORT was used in all cases. The mean follow-up was 57.3 months. The overall rate of regional control was 93.6% (97.7% for RND and 93.5% for MRND; p=0.35). Patients having undergone MRND had a better prognosis and less recurrence then patients having undergone RND (respectively p=0.007, and p=0.0004).


CONCLUSIONS
MRND in association with PORT is an effective treatment in patients with advanced head and neck epidermoid carcinoma staged N2 and N3.
Zwetyenga
N
N
Department of Maxillofacial and Plastic Surgery, University hospital of Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. nzwetyenga@gmail.com <nzwetyenga@gmail.com>
Fricain
J-C
JC
Demeaux
H
H
Deminière
C
C
Siberchicot
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D011182:Postoperative Care; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D055815:Young Adult