Results of Selective Neck Dissection in Management of the Node-Positive Neck

Andersen, Peter E.; Warren, Frank M.; Spiro, Jeffrey D.; Burningham, Alan R.; Wong, Richard J.; Wax, Mark K.; Shah, Jatin P.; Cohen, James I.

doi:10.1001/archotol.128.10.1180

Cited by 134 publications

(103 citation statements)

References 20 publications

(26 reference statements)

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“…Several authors have reported similar control rates with selective node dissection in the N+ neck [9,10]. Andersen et al reported a 94.3 % regional control rates in node positive patients undergoing a SND [11]. Kowalski et al did not find isolated pN+ nodes at level IV or V in their analysis of N+ patients, results similar to this study.…”

Section: Discussionsupporting

confidence: 87%

Are We Over-treating Neck in Buccal & Alveolo-buccal Cancers: Experience from a Tertiary Cancer Care Center

Deo

Shukla

Jha

et al. 2012

Indian J Surg Oncol

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Oral cancer is one of the most common types of cancer seen in India with buccal and alveolo buccal regions being the most frequent subsites. A retrospective analysis of buccal and alveolo buccal cancer patients undergoing neck dissection from 1995 to 2009 was performed to analyze the profile of neck dissections and patterns of nodal involvement in these patients. Total 310 neck dissections were done for buccal and alveolo-buccal cancer including 41 (13.2 %) RND, 231(74.5 %) MND and 38 (12.2 %) Supraomohyoid neck dissection (SOHND). Clinically palpable nodes were present in 75.9 % patients but only 117 (38 %) were pathologically node positive. 20 % had occult positive nodes in N0 group. Level I was most commonly involved with 35 % having positive nodes in more than one level. There were no patients with isolated involvement of level IV or V with only 3.9 % patients with involvement of level III. Current guidelines recommend neck dissection in all clinically node positive patients. However, our experience shows that neck is over treated in majority of patients and there is a need to optimize surgical management of neck in these patients.

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Section: Discussionsupporting

confidence: 87%

Are We Over-treating Neck in Buccal & Alveolo-buccal Cancers: Experience from a Tertiary Cancer Care Center

Deo

Shukla

Jha

et al. 2012

Indian J Surg Oncol

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“…rates, as long as this does not cause a negative impact on disease control. 15 Several studies have been showing that SND for treating N0 necks and MRND for N+ necks are sufficient for the majority of cases. Careful selection of the type of dissection to be performed, together with judicious indication of postoperative radiotherapy, can improve cure rates as well as the functional and esthetic results.…”

Section: Resultsmentioning

confidence: 99%

“…Careful selection of the type of dissection to be performed, together with judicious indication of postoperative radiotherapy, can improve cure rates as well as the functional and esthetic results. 15 Some studies have recently suggested and others have demonstrated that SND could be used for selected patients with a node-positive neck when they present clinical staging lower than N2A and when there is no capsule rupture. Some authors have suggested using postoperative radiotherapy.…”

Section: Resultsmentioning

confidence: 99%

Selective neck dissection for treating node-positive necks in cases of squamous cell carcinoma of the upper aerodigestive tract

Antonio¹,

Menezes²,

Kavabata³

et al. 2008

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Modified radical neck dissection (MRND) is the classical treatment for neck metastases of squamous cell carcinoma (SCC) of the upper aerodigestive tract. However, it may still be accompanied by significant sequelae. One alternative for this treatment would be selective neck dissection (SND), which has a lower incidence of sequelae. The aim of this study was to define which neck metastasis cases would really be suitable candidates for SND. DESIGN AND SETTING: Retrospective clinical-surgical trial at the Division of Head and Neck Surgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP). METHODS: We retrospectively studied 67 patients with SCC of the upper aerodigestive tract, divided into two groups: 1) 47 patients treated by means of SND (node-negative or node-positive), 2) 20 patients treated by means of MRND (all node-positive). RESULTS: Our results demonstrated that there was no difference between the patients treated with SND or MRND in relation to disease evolution, and that the main prognostic factor was lymph node involvement. We observed that patients with pharyngeal SCC and older patients presented worse evolution and would probably not be suitable candidates for SND. CONCLUSIONS: SND may be a good option for treating node-positive necks in selected cases.

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“…SBD'nun N(+) hastalarda kullanılabileceğini savunan araştırmacılar da mevcuttur (19)(20)(21). Buna ek olarak süper SBD'nun ileri evre baş-boyun kanseri olan ve kemo-radyoterapi ile tedavi edilen hastalar için etkili bir müdahale olduğu, tespit edilmiştir ( 22 ).…”

Section: Discussionunclassified

Advantages of Selective Neck Dissection, A 3-Year Follow-up Study

Ulu¹,

Cömert²,

Arslan³

et al. 2015

Turk J Bioch

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Amaç: Baş-boyun bölgesi kanserlerinin temel yayılımı lenfatik sistem yolu ile olur. Bu bölge tümörlerinin tedavisini yapacak olan bir hekimin lenfatik yayılımı mutlaka göz önünde bulundurması gerekir. Boyunda klinik olarak palpe edilebilen, metastatik lenfadenopatisi olan hastalarda tedavi için fikir birliği sağlanmış olmasına rağmen, N0 boyunlarda tedavi yöntemi hakkında net bir görüş yoktur. Selektif boyun diseksiyonu(SBD) genellikle primer tümörün lokalizasyonuna göre yapılmaktadır. Hem N0 hem de N+ hastalarda yapılabilmektedir. Yöntem: Çalışmamızda baş boyun malign tümörü nedeniyle opere edilen 45 hasta ve bu hastalara yapılan 79 selektif boyun diseksiyonu değerlendirildi. SBD yapılan hastaların 3 yıllık takip sonuçları incelendi. Bulgular: Çalışmaya katılan hastaların 3 yıllık sağkalım oranı %92 olarak bulundu. Ortalama 3 yıllık takiplerde 4 hastada (%8,8) boyunda rekürrens görüldü. Hiç bir hastamızda IIb bölgesine metastaz tespit edilmedi. SBD yapılan hastalarımızda daha az komplikasyon gözlendi ve diğer boyun diseksiyonlarına göre daha kısa bir sürede yapıldı. Sonuç: Sonuç olarak SBD'nun süre ve komplikasyon avantajları nedeniyle her geçen gün daha çok tercih edilen bir yöntem olmaktadır. İleride, baş boyun kanserlerinde geniş serilerle yapılacak çalışmalarla süper SBD'nun daha yaygın hale geleceğine inanmaktayız. Objective:The main spread of head and neck cancers is through lymphatic system. A physician who will treat this region tumors should keep in mind lymphatic spread. Although there is a consensus for treatment of patients who have palpable lymphadenopathy at neck, the discussion is still ongoing for the treatment of N0 necks. Selective neck dissection is usually performed according to the localization of the primary tumor. It can be performed to bothN0 and N + patients. Method: In our study, patients who had selective neck dissection due to head and neck malignant tumor and their Lymph node spreads were evaluated along with preoperative -postoperative imaging methods and pathology reports. 3-year follow-up results were analyzed. Results: A 3-year survival rate of 45 patients who had selective neck dissection and included in the study was found to be 92%. During 3-year follow-up period, neck recurrence was observed in 4 patients (8.8%). Of these 4 patients, 2 patients were followed up for larynx carcinoma and other 2 patients were followed up for lower lip carcinomas. Conclusion: In conclusion, due to the advantages of time and complications the reliability of selective neck dissection increases year after year. We believe that, with larger series of head and neck cancer, super-selective neck dissection will become more widely in the future. Anahtar Kelimeler: Boyun diseksiyonu, selektif boyun diseksiyonu, metastaz.

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Results of Selective Neck Dissection in Management of the Node-Positive Neck

Cited by 134 publications

References 20 publications

Are We Over-treating Neck in Buccal & Alveolo-buccal Cancers: Experience from a Tertiary Cancer Care Center

Are We Over-treating Neck in Buccal & Alveolo-buccal Cancers: Experience from a Tertiary Cancer Care Center

Selective neck dissection for treating node-positive necks in cases of squamous cell carcinoma of the upper aerodigestive tract

Advantages of Selective Neck Dissection, A 3-Year Follow-up Study

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