The role of elective neck dissection during salvage surgery in head and neck squamous cell carcinoma

Abstract

Conclusion: As the occult nodal metastasis ratio is low and there is no statistical benefit of elective neck dissection, elective neck dissection is not always necessary during salvage surgery. However, in patients with N positive at initial treatment and cases developing a recurrence within 1 year, elective neck dissection should be considered during salvage surgery. Objectives: The aim of this study was to evaluate the role of ipsilateral or contralateral elective neck dissection during salvage surgery in head and neck squamous cell carcinoma. Methods: A total of 154 node negative and previously undissected heminecks were electively dissected or observed. We estimated the occult metastasis rate in the electively dissected group and compared the regional control rate and disease-specific survival rate between the elective neck dissection group and the observation group. Results: Six of 80 electively dissected heminecks (7.5%) had occult nodal metastasis. When comparing the regional control rate and disease-specific survival rate between the elective neck dissection group and the observation group, there was no statistically significant difference between groups. However, N-positive cases at initial treatment and recurrent cases that developed within 1 year had a significant advantage for elective neck dissection during salvage surgery.

Keywords::

• Elective neck dissection
• salvage surgery
• head and neck squamous cell carcinoma