title: Regional failures after selective neck dissection in previously untreated squamous cell carcinoma of oral cavity.
abstract: OBJECTIVE
  To share experience with regional failures after selective neck dissection in both node negative and positive previously untreated patients diagnosed with squamous cell carcinoma of the oral cavity.
  
  
  METHODS
  Data of 219 patients who underwent SND at Shaukat Khanum Cancer Hospital from 2003 to 2010 were retrospectively reviewed. Patient characteristics, treatment modalities, and regional failures were assessed. Expected 5-year regional control was calculated and prognostic factors were determined.
  
  
  RESULTS
  Median follow-up was 29 (9-109) months. Common sites were anterior tongue in 159 and buccal mucosa in 22 patients. Pathological nodal stage was N0 in 114, N1 in 32, N2b in 67, and N2c in 5 patients. Fourteen (6%) patients failed in clinically node negative neck while 8 (4%) failed in clinically node positive patients. Out of 22 total regional failures, primary tumor origin was from tongue in 16 (73%) patients. Expected 5-year regional control was 95% and 81% for N0 and N+ disease, respectively (P < 0.0001). Only 13% patients with well differentiated, T1 tumors in cN0 neck were pathologically node positive.
  
  
  CONCLUSIONS
  Selective neck dissection yields acceptable results for regional management of oral squamous cell carcinoma. Wait and see policy may be effective in a selected subgroup of patients.
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7A Block R-3, M.A.   Johar Town, Lahore, Pakistan.
authors.forename: Hassan
authors.initials: H
authors.lastname: Iqbal
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7A Block R-3, M.A.   Johar Town, Lahore, Pakistan.
authors.forename: Abu Bakar Hafeez
authors.initials: AB
authors.lastname: Bhatti
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7A Block R-3, M.A.   Johar Town, Lahore, Pakistan.
authors.forename: Raza
authors.initials: R
authors.lastname: Hussain
authors.affiliation: Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7A Block R-3, M.A.   Johar Town, Lahore, Pakistan.
authors.forename: Arif
authors.initials: A
authors.lastname: Jamshed
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D017211:Treatment Failure; D055815:Young Adult
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