Modified radical neck dissection vs. selective neck dissection: an analysis of lymph node yield and post-surgical outcomes

Abstract

Background Modified radical neck dissection (MRND) and selective neck dissection (SND) are widely used techniques for the management of metastatic squamous cell carcinoma (SCC) involving the lymph nodes of the neck. This study compared the yield of lymph nodes for both techniques and evaluated clinically relevant outcomes. Methods A retrospective study design was utilised. Patients undergoing either the MRND or SND between January 2010 and March 2012 for metastatic SCC were eligible for inclusion. The primary outcome was mean number of lymph nodes extracted per neck level. Secondary outcomes were all cause mortality, regional recurrence and complications. Results Fifty-two patients who underwent 58 neck dissections (12 MRND and 46 SND) were included in the final analysis with a mean follow-up of approximately 1 year for both groups. No significant differences were observed between the groups with regards to follow-up time, age or gender. No significant differences were observed in terms of surgical complications including haematoma, infection and thromboembolic complications. Both the MRND and SND were found to be similar in terms of the number of lymph nodes extracted per anatomical neck level (p>0.05 for levels I-V). There were no significant differences between the MRND and SND in terms of regional recurrence and overall survival. Conclusions Our results showed no difference between the MRND and SND in terms of lymph node yield after adjusting for the number of anatomical levels dissected. The MRND and SND also demonstrated similar complication profiles and rates of recurrence and survival. Level of evidence: Level III, risk/prognostic study