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

2008 ◽  
Vol 126 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Jamile Karina Antonio ◽  
Marcelo Benedito Menezes ◽  
Norberto Kodi Kavabata ◽  
Antonio Augusto Tupinambá Bertelli ◽  
William Kikuchi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Radical Neck Dissection ◽  
Aerodigestive Tract ◽  
Selective Neck Dissection ◽  
Upper Aerodigestive Tract ◽  
Disease Evolution ◽  
Node Positive

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.

scholarly journals Selective Neck Dissection and Survival in Pathologically Node-Positive Oral Squamous Cell Carcinoma

Cancers ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 269 ◽  
Author(s):  
Shunichi Shimura ◽  
Kazuhiro Ogi ◽  
Akihiro Miyazaki ◽  
Shota Shimizu ◽  
Takeshi Kaneko ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Radical Neck Dissection ◽  
Selective Neck Dissection ◽  
Neck Node ◽  
Node Positive

The most important prognostic factor in oral squamous cell carcinoma (OSCC) is neck metastasis, which is treated by neck dissection. Although selective neck dissection (SND) is a useful tool for clinically node-negative OSCC, its efficacy for neck node-positive OSCC has not been established. Sixty-eight OSCC patients with pN1–3 disease who were treated with curative surgery using SND and/or modified-radical/radical neck dissection (MRND/RND) were retrospectively reviewed. The neck control rate was 94% for pN1–3 patients who underwent SND. The five-year overall survival (OS) and disease-specific survival (DSS) in pN1-3 OSCC patients were 62% and 71%, respectively. The multivariate analysis of clinical and pathological variables identified the number of positive nodes as an independent predictor of SND outcome (OS, hazard ratio (HR) = 4.98, 95% confidence interval (CI): 1.48–16.72, p < 0.01; DSS, HR = 6.44, 95% CI: 1.76–23.50, p < 0.01). The results of this retrospective study showed that only SND for neck node-positive OSCC was appropriate for those with up to 2 lymph nodes that had a largest diameter ≤3 cm without extranodal extension (ENE) of the neck and adjuvant radiotherapy. However, the availability of postoperative therapeutic options for high-risk OSCC, including ENE and/or multiple positive lymph nodes, needs to be further investigated.

scholarly journals Regional Failures after Selective Neck Dissection in Previously Untreated Squamous Cell Carcinoma of Oral Cavity

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Hassan Iqbal ◽  
Abu Bakar Hafeez Bhatti ◽  
Raza Hussain ◽  
Arif Jamshed
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Neck Dissection ◽  
Squamous Cell ◽  
Treatment Modalities ◽  
Selective Neck Dissection ◽  
Node Negative ◽  
Node Positive ◽  
Regional Control

Aim. To share experience with regional failures after selective neck dissection in both node negative and positive previously untreated patients diagnosed with squamous cell carcinoma of the oral cavity.Patients and Methods. Data of 219 patients who underwent SND at Shaukat Khanum Cancer Hospital from 2003 to 2010 were retrospectively reviewed. Patient characteristics, treatment modalities, and regional failures were assessed. Expected 5-year regional control was calculated and prognostic factors were determined.Results. Median follow-up was 29 (9–109) months. Common sites were anterior tongue in 159 and buccal mucosa in 22 patients. Pathological nodal stage was N0 in 114, N1 in 32, N2b in 67, and N2c in 5 patients. Fourteen (6%) patients failed in clinically node negative neck while 8 (4%) failed in clinically node positive patients. Out of 22 total regional failures, primary tumor origin was from tongue in 16 (73%) patients. Expected 5-year regional control was 95% and 81% for N0 and N+ disease, respectively (P<0.0001). Only 13% patients with well differentiated, T1 tumors in cN0 neck were pathologically node positive.Conclusions. Selective neck dissection yields acceptable results for regional management of oral squamous cell carcinoma. Wait and see policy may be effective in a selected subgroup of patients.

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