title: Prognostic role of internal jugular vein preservation in neck dissection for head and neck cancer.
abstract: OBJECTIVE
  Sparing internal jugular vein (IJV) in neck dissection for head and neck cancer is controversial. We aimed at evaluating the prognostic impact of IJV preservation.
  
  
  METHODS
  We examined 206 files of head and neck cancer patients who underwent radical or modified radical neck dissection at the Otolaryngology University of Florence. The site of primary tumor was larynx and hypopharynx in 44.66%, oropharynx in 25.24%, oral cavity in 23.3%, unknown in 4.85%, salivary glands and rhinopharynx in 0.97%. In 60.19% the IJV was resected, in 39.81% preserved. Prognostic impact of IJV preservation was assessed by Kaplan-Meier and multivariate analysis.
  
  
  RESULTS
  Neck recurrence occurred in 25.2%: the IJV was resected in 42.31%, in 57.69% preserved (P = 0.02). At multivariate analysis, neck recurrence resulted significantly associated to extracapsular spread (ECS) (P = 0.009), IJV preservation (P = 0.01), positive margins (P = 0.02). In ECS positive patients, a higher risk of neck recurrence was documented for IJV preservation (P = 0.012). A worse prognosis was observed for patients with IJV spared (P = 0.06).
  
  
  CONCLUSIONS
  IJV preservation is associated with an increased risk of neck failure and a worse outcome, mainly in patients with ECS of nodes.
authors.affiliation: Academic Clinic of Otolaryngology and Head and Neck Surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
authors.forename: O
authors.initials: O
authors.lastname: Gallo
authors.forename: R
authors.initials: R
authors.lastname: Santoro
authors.forename: F R
authors.initials: FR
authors.lastname: Fiorini
authors.forename: G
authors.initials: G
authors.lastname: Meccariello
authors.forename: R M
authors.initials: RM
authors.lastname: Laganà
authors.forename: F
authors.initials: F
authors.lastname: Paiar
authors.forename: V
authors.initials: V
authors.lastname: Maio
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000517:prevention & control* / Q000601:surgery*; D006801:Humans; D007601:Jugular Veins / Q000473:pathology / Q000601:surgery*; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome
keywords: extracapsular spread; head and neck squamous cell carcinoma; internal jugular vein; neck dissection; neck recurrence