Efficacy of selective neck dissection: A review of 503 cases of elective and therapeutic treatment of the neck in Squamous cell carcinoma of the upper aerodigestive tract

OBJECTIVE: The purpose of this study was to evaluate the efficacy of select ive neck dissection (SND) in elective and therapeutic treatment of the neck . METHODS: A retrospective review was undertaken of 503 previously untreated patients undergoing 711 SNDs as a part of initial therapy for squamous cell carcinoma of the larynx, oral cavity, oropharynx, and hypopharynx from Aug ust 1986 to June 1997 at a single institution. Lymph nodes were pathologica lly negative in 249 and positive in 254 patients. Postoperative radiotherap y was given to 14.5% of the node-negative and 62.2% of the node-positive pa tients. The median follow-up interval was 41 months. RESULTS: The 3-year regional recurrence rates estimated according to Kaplan -Meier were as follows: pN0, 4.7%; pN1, 4.9%; pN2, 12.1%. A comparison of r ecurrence rates with respect to the extent of neck disease and postoperativ e radiotherapy demonstrated a tendency to an improved regional control in i rradiated patients with one metastasis and a distinctly improved regional c ontrol in patients with multiple metastases or metastases with extracapsula r spread. CONCLUSION: The results achieved with SND compare favorably with the result s reported for modified radical neck dissection. The application of SND mig ht be extended to more advanced neck disease.