Efficacy Of Selective Neck Dissection In Elective And Therapeutic Treatment Of The Neck In Squamous Cell Carcinoma Of Head And Neck.

Objective:The purposes of this study were: 1) to evaluate the efficacy of selective neck dissection (SND) in the treatment of the neck in squamous cell carcinoma of head and neck; 2) to compare the effectiveness of SND with comprehensive neck dissection (CND) for the management of supraglottic cancer with pathologically negative nodes (pNO); 3) to investigate comparatively the shoulder function, sensory and cosmetic changes after SND, modified neck dissection(MND) and radical neck dissection(RND) Methods:(1) A retrospective review was undertaken of 123 patients undergoing 157 SNDs as a part of initial therapy for squamous cell carcinoma (SCC)of head and neck from January 1997 to September 2001 at this institute. The primary site included larynx (n=77), oral cavity (n=29), oropharynx(n=2), and hypopharynx(n=15). Lymph nodes were pathologically negative (pNO) in 99 and positive (pN+) in 24 patients.(2) Two treatment groups with pNO supraglottic cancer were retrospectively compared: 61 patients who were treated with CND between March of 1979 and December of 1996, and 55 patients who were treated with SND between January of 1997 and December of 2001.(3) Questionnaires were send to 234 patients with SCC of head and neck who were treated with SND, MND or RND between Janunary 1997 and May 2001. 32 eligible questionnaires were collected which included 32 patients had 43 neck dissection. Among them, SNDs were performed in 23 necks, MNDs in 11 necks and RND in 9 necks.Results:(1) 101 patients received elective neck dissection, 14 of them (13.9%) found to...