Crile's Neck Dissection

Silver, Carl E.; Rinaldo, Alessandra; Ferlito, Alfio

doi:10.1097/mlg.0b013e31813544b7

Cited by 20 publications

(9 citation statements)

References 4 publications

(12 reference statements)

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“…It was so iconic that it became the symbolic operation of Head and Neck Surgery 21,22 . However, since its initial description in English literature in 1906 by George W. Crile 23,24 , proposals for modifications have arisen, derived from the original operation, called classical radical neck dissection. These changes were aimed at restricting the extent of resection of both lymphatic and non-lymphatic structures, aiming to reduce the mortality associated with the procedure 25,26 .…”

Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy in early oral cavity tumors: evaluation of the oncologic efficacy compared to elective neck dissection

Seferin¹,

Pinto²,

Lin³

et al. 2018

Arch. Head Neck Surg.

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Introduction:In recent years, there has been a polarization around the discussion of neck management in patients with oral malignant neoplasm without evidence of lymph node involvement, regarding selective neck dissection (SND) of levels I, II and III, sentinel lymph node biopsy (SLB) and just surveillance. Objective: To describe the oncological results of a prospective study in the use of sentinel lymph node biopsy as part of the surgical treatment of squamous cell carcinoma T1/T2N0 of the oral cavity in comparison to the results of patients submitted to levels I, II and III SND. Methods: It was a prospective study in which seventy patients were divided into two groups, 35 being submitted to SND and the other 35 to SLB. Results: In the SND group, locoregional recurrence occurred in 17.1%, with a 2.9% development of distant metastasis and 8.8% evolved with a second primary tumor. In the SLB, locoregional recurrence was observed in 7 patients (20.0%), 5.7% developed distant metastasis, and 5.7% had a second primary tumor. There was no significant difference between the two groups for both overall (p = 0.521) and disease-free survival (p = 0.753). Conclusion: A SLB is reliable for the management of clinically negative neck in patients with oral T1/T2N0 squamous cell carcinoma.

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Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy in early oral cavity tumors: evaluation of the oncologic efficacy compared to elective neck dissection

Seferin¹,

Pinto²,

Lin³

et al. 2018

Arch. Head Neck Surg.

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“…Crile reported in 1905 that en bloc resection of lymph nodes by neck dissection could treat regional metastases of head and neck cancers (Crile,1905), and cervical lymphadenectomy for cancerous nodes remains one of the tenets of surgical management of HNSCC today (Silver et al,2007). The goal of the neck dissection was at that time and remains today to remove tumor and to reduce the risk of spread of metastasis and the probability of cancer recurrence.…”

Section: The Lymphatic System In the Head And Neck Regionmentioning

confidence: 99%

Pathways for cervical metastasis in malignant neoplasms of the head and neck region

Wang

Myers

2011

Clinical Anatomy

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There have been significant changes in the evaluation and management of lymphatic metastases in the neck during the past several decades, and knowledge of the functional anatomy of the cervical lymphatics is fundamental to the clinical management of metastasis in this region. This review provides a comprehensive description of the cervical lymphatics and discusses how this knowledge is used in the modern management of the neck lymphatics in the setting of common cancers of the head and neck. The patterns of tumor spread can be delineated based on the well-studied functional anatomy of the lymphatic networks in the cervical region. The characteristics and patterns of metastatic spread for two common cancers found in this region, squamous cell carcinoma and cutaneous malignant melanoma, are discussed in this review. Significant improvements in clinical care, namely, selective neck dissection and sentinel lymph node biopsy aided by lymphoscintigraphy, have been developed and are based upon detailed studies of the pathways of metastatic spread. These advances have significantly decreased the morbidity associated with the evaluation and treatment of metastatic disease to the neck.

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“…More than 100 years after Crile first presented his series of cervical lymphadenectomies [1], debate continues over the technique, extent, and clinical benefit of neck dissection (ND) in the treatment of head and neck squamous cell carcinoma (SCC) [2]. As a result of the enlightenment provided by Suárez [3], management of the neck has decidedly moved away from radical ND towards less morbid functional or even selective approaches in elective cases (i.e., ND in those without clinically-detectable cervical lymphadenopathy or cN0 necks) and increasingly in therapeutic cases (i.e., ND in those with clinically-detectable cervical lymphadenopathy or cN?…”

Section: Introductionmentioning

confidence: 99%

Nodal yield of neck dissections and influence on outcome in laryngectomized patients

Böttcher

Dommerich

Sander

et al. 2016

Eur Arch Otorhinolaryngol

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The appropriate extent of neck dissection (ND) in head and neck squamous cell carcinoma (SCC) continues to be investigated. This study aimed to determine whether the extent of ND as measured by nodal yield (NY) is a prognostic factor in patients undergoing primary total laryngectomy (TL) for advanced laryngeal SCC. A retrospective review at a tertiary referral centre identified 54 patients who underwent TL with elective (n = 39, cN0) or therapeutic (n = 15, cN+) ND with curative intent between 2002 and 2014. Survival analysis was obtained via regression analysis, calculated for overall (OS) and disease-free survival (DFS). Stage-independent 5-year OS was 32.1 %. Mean NY was 18.67 (standard deviation 9.898; range 0-45). The rate of cervical lymph node metastasis on pathology (pN+) was 27.8 %. Uni- and multivariate regression analysis detected no association between NY and OS or DFS (P ≥ 0.05). Advantages in OS and DFS were seen among patients without cervical lymph node metastasis (pN0) in comparison to those with pN+ necks (OS: hazard ratio [HR] 0.179; 95 % confidence interval [CI] 0.046-0.693; P = 0.013, and DFS: HR 0.190; 95 % CI 0.061-0.590; P = 0.004). ND resulted in pathologic upstaging of the neck in seven patients and downgrading in eight; increasing NY was not associated with an increased probability of a change in nodal stage. No significant association was found between NY and OS or DFS in patients undergoing TL with ND as primary therapy for advanced laryngeal SCC.

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Crile's Neck Dissection

Cited by 20 publications

References 4 publications

Sentinel lymph node biopsy in early oral cavity tumors: evaluation of the oncologic efficacy compared to elective neck dissection

Sentinel lymph node biopsy in early oral cavity tumors: evaluation of the oncologic efficacy compared to elective neck dissection

Pathways for cervical metastasis in malignant neoplasms of the head and neck region

Nodal yield of neck dissections and influence on outcome in laryngectomized patients

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