Selective Neck Dissection for the Treatment of Neck Metastasis From Squamous Cell Carcinoma of the Head and Neck

Chepeha, Douglas B.; Hoff, Paul T.; Taylor, Rodney J.; Bradford, Carol R.; Teknos, Theodoros N.; Esclamado, Ramon M.

doi:10.1097/00005537-200203000-00005

Cited by 67 publications

(53 citation statements)

References 15 publications

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“…Their reported pN0 rate was 57.4 % in this subset of patients, which is similar to our rate [12]. Chepeha et al reported comparable regional control rates in N+ patients undergoing SND followed by RT as compared to patients subjected to MND with RT [13]. Medina et al reported a 12.5 % regional failure rate in N+ patients undergoing SND and RT [14].…”

Section: Discussionsupporting

confidence: 86%

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: 86%

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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“…Regional control in patients undergoing selective neck dissection with radiotherapy compared to modified neck dissections with radiotherapy has been demonstrated to be comparable in patients with a N0 to N2c nodal stage. 13 Regional recurrence rates are also comparable for radical (17.5%, CI 13.1-21.9) and modified radical neck dissections (14.3%; CI 7.1-21.5) with radiotherapy in patients with advanced neck disease (N2 or greater). 14 The regional recurrence rates reported in this study are, therefore, similar to those reported in the literature.…”

Section: Discussionmentioning

confidence: 78%

Outcomes in Squamous Cell Carcinoma with Advanced Neck Disease

Keir

Whiteside

Winter

et al. 2007

annals

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INTRODUCTION Treatment of advanced neck disease (N2c/N3) in head and neck squamous cell carcinoma is contentious. The aim of this study was to review the survival outcome following surgical excision of neck disease and the complications of this surgery. PATIENTS AND METHODS A retrospective review of the case notes of 39 patients treated at the Oxford Radcliffe Infirmary Head and Neck Unit with squamous cell carcinoma and advanced neck metastases confirmed as either pN2c or pN3 on histological examination was performed. Patients were treated with surgery and, in some cases, with adjunctive postoperative radiotherapy at the centre between August 1996 and November 2004. The study sought to establish the demographics, UICC staging/pathology, method of treatment, complications, recurrence and survival. Kaplan-Meier curves were used for statistical analysis of survival. Comparisons were then made between the cohort and historical control groups. RESULTS All patients were UICC stage IV disease. The 2- and 5-year overall survival in patients with resectable disease was 63% and 52%, respectively. DISCUSSION Patients with advanced neck disease have traditionally been thought to have terrible prognosis and, therefore, treatment is controversial. In treating advanced head and neck cancer, there has been a recent trend away from surgery towards chemotherapy and/or radiotherapy. CONCLUSIONS Comparing this study group to historical controls that include chemotherapy and/or radiotherapy, the outcomes appear favourable. The use of a combination of radiotherapy and surgery is advocated; it is suggested that advanced neck disease can have an acceptable prognosis and morbidity and that local disease control may be achieved.

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“…Of 4.5% neck recurrences after selective neck dissection, Carvalho et al (2000) found 57.1% of them to be inside the limits of dissection. Similarly, Anderson et al (2002) and Chepeha et al (2002) reported two-thirds of recurrences following SOHND to be in the field of dissection. Whitehurst and Droulias (1977) reported that 85% of the locoregional recurrences after surgical excision of tongue carcinoma occurred within 1 year, 95% within 2 years and 100% in 3 years.…”

Section: Discussionmentioning

confidence: 84%

Conservative Neck Dissection in Oral Cancer Patients: a 5 Year Retrospective Study in Malaysia

Balasundram

Mustafa²,

Ip³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Selective Neck Dissection for the Treatment of Neck Metastasis From Squamous Cell Carcinoma of the Head and Neck

Abstract: With similar indications for radiation therapy, the regional control rate in this cohort is comparable to control rates obtained with modified radical neck dissection.

Cited by 67 publications

References 15 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

Outcomes in Squamous Cell Carcinoma with Advanced Neck Disease

Conservative Neck Dissection in Oral Cancer Patients: a 5 Year Retrospective Study in Malaysia

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