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Eur J Surg Oncol. 2018 Apr;44(4):395-403. doi: 10.1016/j.ejso.2018.01.003. Epub 2018 Jan 11.

Selective neck dissection in surgically treated head and neck squamous cell carcinoma patients with a clinically positive neck: Systematic review.

Author information

1
Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPA, University of Oviedo, CIBERONC, Oviedo, Spain. Electronic address: juanpablo.rodrigo@sespa.es.
2
Division of Otolaryngology, Ospedali Riuniti, Foggia, Italy.
3
Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
4
Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
5
Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
6
Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
7
Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital and Cancer Center, Brussels, Belgium.
8
Department Otorhinolaryngology-Head and Neck Surgery, Centro de Tratamento e Pesquisa Hospital do Cancer A.C. Camargo, São Paulo, Brazil.
9
Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain.
10
Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPA, University of Oviedo, CIBERONC, Oviedo, Spain.
11
Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
12
Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Freiburg, Germany.
13
Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
14
Department of Otolaryngology-Head and Neck Surgery, Uludag University School of Medicine, Bursa, Turkey.
15
University of Udine School of Medicine, Udine, Italy.
16
Department of Surgery, University of Arizona College of Medicine, Phoenix, AZ, USA.
17
International Head and Neck Scientific Group, Padua, Italy.

Abstract

Adequate treatment of lymph node metastases is essential for patients with head and neck squamous cell carcinoma (HNSCC). However, there is still no consensus on the optimal surgical treatment of the neck for patients with a clinically positive (cN+) neck. In this review, we analyzed current literature about the feasibility of selective neck dissection (SND) in surgically treated HNSCC patients with cN + neck using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. From the reviewed literature, it seems that SND is a valid option in patients with cN1 and selected cN2 neck disease (non-fixed nodes, absence of palpable metastases at level IV or V, or large volume ->3 cm-multiple lymph nodes at multiple levels). Adjuvant (chemo) radiotherapy is fundamental to achieve good control rates in pN2 cases. The use of SND instead a comprehensive neck dissection (CND) could result in reduced morbidity and better functional results. We conclude that SND could replace a CND without compromising oncologic efficacy in cN1 and cN2 cases with the above-mentioned characteristics.

KEYWORDS:

Hypopharyngeal carcinoma; Laryngeal carcinoma; Node-positive neck; Oral cavity carcinoma; Oropharyngeal carcinoma; Selective neck dissection; Therapeutic

PMID:
29395434
DOI:
10.1016/j.ejso.2018.01.003
[Indexed for MEDLINE]

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