Efficacy of selective neck dissection for nodal metastasis with involvement of nonlymphatic structures.

Abstract

Our aim in carrying out this study was to determine the efficacy of selective neck dissection (SND) for cervical metastases with clinical involvement of adjacent nonlymphatic structures. In all, 39 patients were retrospectively analyzed with respect to 43 extended selective neck dissection (ESND) procedures. Eighteen procedures were performed as part of the primary treatment and 25 for salvage following (chemo)radiation. Although most patients (84%) had nodal disease ≥N2, 91% had disease clinically confined to ≤2 neck levels. SND (levels II-IV) was most commonly performed and the internal jugular vein was the nonlymphatic structure most often sacrificed. Recurrence rate in the ipsilateral targeted neck was 0% and 13% in the primary surgery and postradiation groups, respectively. SND that is extended to include adjacent nonlymphatic structures appears to be effective for advanced nodal metastasis confined to ≤2 nodal levels. We support the use of the term "extended selective neck dissection (ESND)" to describe this modification of neck dissection.