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Effectiveness of selective neck dissection in the treatment of the clinically positive neck
Author(s) -
Patel Rajan S.,
Clark Jonathan R.,
Gao Kan,
O'Brien Christopher J.
Publication year - 2008
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20870
Subject(s) - medicine , neck dissection , surgery , dissection (medical) , head and neck squamous cell carcinoma , head and neck , retrospective cohort study , basal cell , head and neck cancer , adverse effect , carcinoma , radiation therapy
Background. The aim of this work was to determine whether or not patients treated with therapeutic selective neck dissection for head and neck squamous cell carcinoma were oncologically disadvantaged compared with those having comprehensive procedures. Methods. The study involves a retrospective review of 232 therapeutic neck dissections with a minimum of 2 years follow‐up. Results. Patients having selective neck dissection had fewer adverse prognostic factors compared with patients having comprehensive dissection (pN2/3, p = .001; and extracapsular spread, p = .001). There were trends toward improved control in the dissected neck (96% vs 86%, p = .06), and disease‐specific survival (59% vs 43%, p = .06) following selective neck dissection. Disease‐specific survival for all patients was adversely affected by pN classification ( p <.001) and extracapsular spread ( p <.001). Conclusions. Patients undergoing aggressive neck surgery had more extensive disease. Selective neck dissection can be used to effectively treat clinically positive nodal disease in selected patients. © 2008 Wiley Periodicals, Inc. Head Neck 2008