title: Selective neck dissection as an early salvage intervention for clinically persistent nodal disease following chemoradiation.
abstract: BACKGROUND
  The aim of this study was to determine the efficacy of selective neck dissection (SND) performed for persistent nodal disease after chemoradiation.
  
  
  METHODS
  Patients treated with definitive chemoradiation for squamous cell carcinoma of the head and neck who subsequently underwent SND for early salvage of clinically persistent nodal disease were evaluated. The primary outcome measure was regional disease control.
  
  
  RESULTS
  A total of 62 patients underwent 69 SND procedures. The median time interval between completion of chemoradiation and neck dissection was 10 weeks. There was evidence of residual tumor in 32 neck dissection specimens (46%). Forty patients (65%) remained free of disease, whereas the remaining 22 patients (35%) developed a recurrence, among which 4 were regional. Of these, 3 occurred in the contralateral neck and only 1 occurred in the targeted (ipsilateral) neck.
  
  
  CONCLUSIONS
  SND is an effective early salvage intervention for persistent nodal disease in patients treated with chemoradiation.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Simmons Cancer Institute at Southern Illinois University, Springfield, Illinois.
authors.forename: Muthuswamy
authors.initials: M
authors.lastname: Dhiwakar
authors.forename: K Thomas
authors.initials: KT
authors.lastname: Robbins
authors.forename: Francisco
authors.initials: F
authors.lastname: Vieira
authors.forename: Krishna
authors.initials: K
authors.lastname: Rao
authors.forename: James
authors.initials: J
authors.lastname: Malone
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D059248:Chemoradiotherapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000473:pathology; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016879:Salvage Therapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed