Neck dissections in the United States from 2000 to 2006: volume, indications, and regionalization.
BACKGROUND
The purpose of this study was to examine trends in neck dissection and regionalization.


METHODS
This cross-sectional and longitudinal study used the years 2000, 2004, and 2006 data from the Nationwide Inpatient Sample. Chi-square tests compared trends for total neck dissections and specific subsites. To test regionalization, we examined the distribution of procedures across hospital and procedure volume quartiles.


RESULTS
From 2000 to 2006, the number of neck dissections increased from 18,112 to 22,918. Three-fourths of the total increase was associated with thyroid and parathyroid gland or skin neoplasms. There was an increase in neck dissections for upper aerodigestive tract (UADT) subsites and no decline for the oropharynx and tongue base. Regionalization occurred as high-volume hospitals and providers performed a greater proportion of neck dissections over time.


CONCLUSIONS
Neck dissections increased from the year 2000 to 2006. There were no decreases in neck dissections for certain subsites with a greater role for primary chemoradiotherapy. Regionalization has occurred.
Kim
Eugene Y
EY
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA.
Eisele
David W
DW
Goldberg
Andrew N
AN
Maselli
Judy
J
Kezirian
Eric J
EJ
D000328:Adult; D017677:Age Distribution; D000368:Aged; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data* / Q000639:trends; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D014481:United States; D016526:Workload / Q000706:statistics & numerical data*