Planned neck dissection for advanced primary head and neck malignancy treated with organ preservation therapy: Disease control and survival outcomes

Background. The role of planned neck dissection after organ preservation th erapy with radiotherapy or chemotherapy/radiotherapy for advanced head and neck cancers presenting with clinically positive neck disease is still bein g elucidated. The aim of this study is to review the outcomes of such patie nts treated by organ preservation therapy at our institution. Methods. A retrospective chart review of 33 patients who underwent planned neck dissections after organ preservation therapy for advanced primary head and neck malignancy. End-points measured were disease-free survival and lo cal, regional, and distant control. Setting. Tertiary metropolitan medical center. Results. Two-year actuarial disease-free survival was 61%, and neck control was 92%, with only two failures in the neck. The use of neoadjuvant chemot herapy and total dose of radiotherapy did not correlate with neck control o r disease-free survival. The presence of pathologically positive nodal dise ase at the time of neck dissection did not correlate with recurrent neck di sease, but was a predictor of local recurrence (p = .0086). Conclusions. Our data suggest that for patients undergoing planned neck dis section after organ preservation therapy, neck control is obtained in almos t all cases. The presence of pathologically positive nodal disease at the t ime of surgery may have implications for the incidence of local recurrence. (C) 2001 John Wiley & Sons, Inc.