1989 Ogura memorial lecture: mediastinal dissection.

The mediastinal dissection was introduced in 1962 to manage an otherwise uniformly fatal problem in head and neck oncology: stomal recurrence of laryngeal, squamous cell cancer. The morbidity and mortality rates continued to be high and the survival rates low, but they were an improvement over those of other treatment plans. Since then, refinements of the ablative techniques and major advances in the reconstructive techniques have significantly decreased morbidity and mortality rates. The most recent data indicate a 45% survival rate at 42 months. It is evident that early diagnosis and staging of stomal recurrences will yield successful results. Because the mediastinal dissection operation is now safe, it should be applied more liberally in head and neck oncology situations such as subglottic extension of laryngeal cancer, advanced thyroid cancers, cervical esophageal and tracheal cancers, and all head and neck tumors with low-nodal disease.