THE POSTEROLATERAL NECK DISSECTION - TECHNIQUE AND RESULTS

Objective: To evaluate the effectiveness of the posterolateral neck di ssection in providing regional control of metastatic disease to the po sterior triangle from head and neck primary tumors as part of a multid isciplinary treatment approach. Design: A case series review of 55 pat ients treated over a 10-year period from 1982 through 1991 with a mini mum of 3 years of follow-up. Factors evaluated included site and histo logic type of primary tumors, extent of surgery performed, other thera pies provided, pathologic findings, and clinical outcome. Setting: The University of Texas M. D. Anderson Cancer Center, Houston. Patients: Forty-six male and nine female patients were studied. Three of them ha d bilateral dissections, for a total of 58 operations. Thirty-five wer e diagnosed as having melanoma; 10, squamous cell carcinoma; and 10, v arious other histologic types. Intervention: All patients underwent a posterolateral neck dissection, either alone or as part of a multidisc iplinary treatment plan. Outcome Measures: Factors reviewed were recur rence, either at the primary site or at a regional site, development o f distant metastases, and surgical morbidity. Results: Our review show ed that, overall, disease was controlled at the site of the primary tu mor in 89% of patients (94% of patients with melanoma) and that region al disease was controlled in 93% of patients (89% of patients with mel anoma). Surgical morbidity was minimal. Conclusion: The ''functional'' posterolateral neck dissection as practiced at the University of Texa s M. D. Anderson Cancer Center is effective surgical therapy that prov ides control of regional metastatic disease to the posterior neck from head and neck primary tumors.