The role of selective neck dissection in squamous epithelial cell carcinoma of the head and neck with lymph node involvement

This study included 242 patients who were diagnosed with squamous epithelial cell carcinoma of the larynx, oropharynx, and hypopharynx and underwent excision of the primary mass and selective neck dissection in Gaziantep University, Faculty of Medicine, Department of Otolaryngology between July 2005 and August 2011. Medical files of a total of 80 patients with squamous epithelial cell carcinoma of the head and neck with lymph node involvement and followed for 24 months minimum were retrospectively analyzed. A total of 162 patients without lymph node involvement based on the pathological examination of the specimens, patients who were followed for <24 months, and those who underwent chemoradiotherapy, followed by neck dissection were excluded. Age of the patients, date of surgery, primary tumor localization, stage of the primary tumor and neck carcinoma, extracapsular invasion, recurrence, adjuvant treatments, and survival rates were recorded. Of the patients, 71 (88.8%) were males and nine (11.2%) were females. The mean age was 58.55±12.33 (range, 27 to 88) years. The mean follow-up was 49.2± 27.3 (range, 24 to 98) months. Eight patients (10%) had recurrent disease during a two-year follow-up period. Local control rate was 90%. No statistically significant association between recurrent neck carcinoma and other variables was found. However, advanced age, laryngeal involvement, advanced T3/4 tumors, pN2 metastasis in lymph nodes, and extracapsular invasion increased the risk of recurrence. Overall survival rate was 87.2%, while disease-specific survival rate was 93.4% during two and three-year follow-up period in patients with lymph node involvement. In conclusion, our study results were consistent with the findings of recurrence and local control rates in the literature. Overall and disease-specific survival rates were also higher compared to the published results. We suggest, therefore, that selective neck dissection is a safe and applicable surgical modality as an alternative to radical or modified radical neck dissection in patients with squamous epithelial cell carcinoma of the head and neck with lymph node involvement. Keywords: Head and neck squamous epithelial cell carcinoma, selective neck dissection, regional recurrence, overall survival, disease spesific survival