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September 1997

Effectiveness of Selective Neck Dissection for Management of the Clinically Negative Neck

Author Affiliations

From the Department of Otolaryngology, School of Medicine, University of Pittsburgh, Pittsburgh, Pa. Dr Pitman is now with the Department of Otolaryngology, Naval Medical Center, Portsmouth, Va.

Arch Otolaryngol Head Neck Surg. 1997;123(9):917-922. doi:10.1001/archotol.1997.01900090023004

Objective:  To determine the effectiveness of selective neck dissection for management of the clinically negative neck in head and neck squamous cell carcinoma.

Design:  A retrospective comparison of patients treated electively with selective neck dissection and comprehensive neck dissection.

Setting:  Academic tertiary referral center.

Patients:  Patients with clinically negative necks and previously untreated head and neck squamous cell carcinoma.

Intervention:  Elective neck dissection, surgical treatment of the primary lesion, and postoperative radiotherapy as indicated.

Outcome Measures:  Regional recurrence, distant metastasis, and disease-free survival.

Results:  Selective neck dissection was as effective as comprehensive procedures for staging the clinically negative neck. Occult metastases had a statistically significant effect on patient outcome as measured by distant metastasis.

Conclusion:  Elective neck dissection provides invaluable staging information, which guides the decision for adjuvant therapy.Arch Otolaryngol Head Neck Surg. 1997;123:917-922