[Efficacy of selective neck dissection: a review of 123 cases of elective and therapeutic treatment of the neck in squamous cell carcinoma of head and neck].

OBJECTIVE

To evaluate the efficacy of selective neck dissection (SND) in elective and therapeutic treatment of the neck in squamous cell carcinoma of head and neck.

METHODS

A retrospective review was undertaken of 123 patients undergoing 157 SNDs as a part of initial therapy for squamous cell carcinoma of head and neck from January 1997 to September 2001 at this institute. The primary site included larynx(n = 77), oral cavity(n = 29), oropharynx(n = 2), and hypopharynx(n = 15). Lymph nodes were pathologically negative (pN0) in 99 and positive (pN+) in 24 patients. Peri-operative radiotherapy was given to 30.3% of pN0 and 50.0% of pN+ patients. The median follow-up interval was 25 months.

RESULTS

101 patients received elective neck dissection, 14 of them (13.9%) found to be pN+, while 22 patients received therapeutic neck dissection, 10 of them (45.5%) found to be pN+. A total of 52 positive nodes were found in 157 SNDs. The distribution of the positive nodes were as follows: Level I 25%; Level II 48%; Level III 25%; Level IV 2%. The 5-year regional recurrence rates estimated according to Kaplan-Meier were 5.87% (95% CI: 0.8%, 10.9%) for the pN0 and 9.2% (95% CI: 0.0%, 21.5%) for pN+ patients.

CONCLUSION

The SND, when carefully indicated, a contribution to the concept of less invasive surgery, offers functional and esthetic advantages without oncologic compromise.