Objectives: To assess the therapeutic role and the effectiveness
of the selective neck dissection in the management
of the clinically node negative neck in the head and neck
squamous cell carcinomas.
Patients and Methods: The charts of 177 patients with
squamous cell carcinoma, who underwent neck dissection
between January 2000 and January 2007, were reviewed
retrospectively. Seventy neck dissections in 58 patients (51
males, 7 females; mean age 63 years; range 21 to 85 years)
in whom the primary site of the lesion was the larynx, oral cavity,
oropharynx and hypopharynx, and who were considered
to have N0 neck and to comply with the study criteria were
included in the study. Details were collected on tumor site and
stage, type of surgery, pathologic N stage, number and size of
pathologic nodes, extracapsular spread of nodes, postoperative
radiotherapy, local recurrence, follow up time and survival
status in all patients.
Results: It was found out that selective neck dissection
operations were performed on 99 of 102 N0 patients. The
follow up time was approximately 23 months in 58 patients
who who were found to comply with the inclusion criteria.
The most frequent site for primary tumor was larynx and most
patients were at T2 stage. Nine patients had pathologically
positive lymph node with occult metastasis rate of 13%. The
overall recurrence rate was 19%. Postoperative radiotherapy
was used as adjuvant therapy in 15 patients. Regional control
rate was lower in patients with pathologically positive lymph
nodes. However, it was not statistically significant.
Conclusion: Selective neck dissection is an effective and
safe method for controlling and staging of the patients with
clinically N0 neck.
FREE FULL TEXTAnahtar Kelimeler: Baş ve boyun kanseri; N0 boyun; selektif boyundiseksiyonu.