title: Selective neck dissection in node-positive squamous cell carcinoma of the head and neck.
abstract: OBJECTIVE
  The optimal type of neck dissection in head and neck squamous cell carcinoma (SCC) with clinical cervical metastases has not been determined. The following study was performed to determine the rate of regional control with selective neck dissection (SND) in these patients.
  
  
  METHODS
  Case series with planned data collection.
  
  
  METHODS
  Single institution, cancer center.
  
  
  METHODS
  Patients with cervical lymph node metastases from mucosal cancers of the head and neck who were treated with SND from 2000 to 2010 were selected. Demographics, tumor characteristics, extent of neck dissection, adjuvant treatments, locoregional control, and survival were recorded. Recurrence in the neck and disease-specific survival (DSS) were primary and secondary end points.
  
  
  RESULTS
  One hundred eight patients underwent SND. Sixty-nine (64%) were male. Median age was 62 (20-89) years. The most common primary site was the oral cavity (71.3%). Ninety-five (88%) received adjuvant treatment. Median follow-up was 21 months. Six patients (5.5%) had isolated recurrence in the dissected neck. Patients with N2C disease had poorer neck recurrence-free survival. At the end of study, 64 (59.3%) patients had no evidence of disease, and 23 (21.3%) had died of disease. Two-year DSS was 76.9%. Number of positive nodes (P = .026) and positive surgical margins (P = .001), among others, were predictors of poorer DSS.
  
  
  CONCLUSIONS
  In a highly selected group of patients with cervical lymph node metastases from head and neck SCC, selective neck dissection is effective in controlling the disease in the neck when performed in the setting of a multimodality treatment, including adjuvant radiotherapy or radiochemotherapy.
authors.affiliation: Department of Otolaryngology-Head and Surgery, University of Toronto, Toronto, Ontario, Canada. babak.givi@utoronto.ca
authors.forename: Babak
authors.initials: B
authors.lastname: Givi
authors.forename: Gary
authors.initials: G
authors.lastname: Linkov
authors.forename: Ian
authors.initials: I
authors.lastname: Ganly
authors.forename: Snehal G
authors.initials: SG
authors.lastname: Patel
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wong
authors.forename: Bhuvanesh
authors.initials: B
authors.lastname: Singh
authors.forename: Jay O
authors.initials: JO
authors.lastname: Boyle
authors.forename: Ashok R
authors.initials: AR
authors.lastname: Shaha
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
authors.forename: Dennis H
authors.initials: DH
authors.lastname: Kraus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012044:Regression Analysis; D015996:Survival Rate; D016896:Treatment Outcome