title: The role of elective neck dissection in patients undergoing salvage laryngectomy.
abstract: BACKGROUND
  We investigated the risk of neck metastases in patients undergoing salvage total laryngectomy in association with previous radiotherapy.
  
  
  METHODS
  The medical records of 42 patients (51 neck specimens) with clinical N0 classification who underwent salvage total laryngectomy in 2 cancer centers were reviewed. Fourteen patients had previous radiotherapy to the central neck and 28 to the central and lateral neck.
  
  
  RESULTS
  Staging before salvage total laryngectomy was similar in both groups. The risk of neck metastases in the central and central/lateral radiation groups was 12% and 18%, respectively (p = .69). Subgroup analysis revealed that 4 of 8 patients initially presenting with clinically N+ had neck metastases before surgery, versus 2 of 26 for those with clinically N0 (p = .015; relative risk [RR] = 4.67). The risk or metastases in the contralateral neck was 0 of 9.
  
  
  CONCLUSIONS
  The risk of neck metastases in patients who undergo either central or central/lateral neck radiotherapy is similar. Elective neck dissection seems appropriate in patients undergoing SLR.
authors.affiliation: The Laboratory for Applied Cancer Research Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Moran
authors.initials: M
authors.lastname: Amit
authors.forename: Ohad
authors.initials: O
authors.lastname: Hilly
authors.forename: Leonor
authors.initials: L
authors.lastname: Leider-Trejo
authors.forename: Aharon
authors.initials: A
authors.lastname: Popovtzer
authors.forename: Orit
authors.initials: O
authors.lastname: Gutfeld
authors.forename: Jacob
authors.initials: J
authors.lastname: Shvero
authors.forename: Dan M
authors.initials: DM
authors.lastname: Fliss
authors.forename: Jacob T
authors.initials: JT
authors.lastname: Cohen
authors.forename: Gideon
authors.initials: G
authors.lastname: Bachar
authors.forename: Ziv
authors.initials: Z
authors.lastname: Gil
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015331:Cohort Studies; D018572:Disease-Free Survival; D017558:Elective Surgical Procedures / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D007825:Laryngectomy / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods* / Q000401:mortality; D020360:Neoadjuvant Therapy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011882:Radiotherapy, High-Energy / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D016879:Salvage Therapy; D016019:Survival Analysis; D016896:Treatment Outcome