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Head Neck. 2015 Jun;37(6):915-26. doi: 10.1002/hed.23689. Epub 2014 Jun 30.

Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, Uludag University School of Medicine, Bursa, Turkey.
2
Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
3
Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois.
4
Departments of Surgery and Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
5
Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
6
Department of Otolaryngology-Head and Neck Surgery, University of Marburg, Marburg, Germany.
7
Department of Otolaryngology-Head and Neck Surgery, Guthrie Health System, Sayre, Pennsylvania.
8
Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
9
Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain.
10
Department of Otorhinolaryngology-Head and Neck Surgery, Kantonsspital, St. Gallen, Switzerland.
11
Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
12
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France.
13
Laboratoire de Phonétique et de Phonologie, Sorbonne Nouvelle, Paris, France.
14
Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
15
Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
16
Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital and Cancer Center, Brussels, Belgium.
17
Department of Surgery, Banner MD Anderson Cancer Center, Gilbert, Arizona.
18
ENT Clinic, University of Udine, Udine, Italy.

Abstract

Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach.

KEYWORDS:

clinically negative neck; clinically positive neck; head and neck squamous cell carcinoma; neck dissection; neck metastasis

PMID:
24623715
PMCID:
PMC4991629
DOI:
10.1002/hed.23689
[Indexed for MEDLINE]
Free PMC Article
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