Salvage neck dissection for isolated neck recurrences in head and neck tumors: Intra and postoperative complications

J Surg Oncol. 2021 Oct;124(5):740-750. doi: 10.1002/jso.26576. Epub 2021 Jun 21.

Abstract

Background and objectives: The current evidence regarding complications after salvage neck dissection (ND) for isolated regional recurrences (IRRs) in head and neck cancers is poor. The aim of this study is to evaluate the incidence and differences in complication rates of salvage ND after primary surgery, radiotherapy, chemoradiotherapy, or combined treatments.

Methods: This was a multicentric retrospective study on 64 patients who underwent salvage ND for IRR in three Italian institutes between 2008 and May 2020.

Results: Complications were detected in 7 of the 34 patients (20.8%) and surgeons described difficult dissection in 20 patients (58.82%). Accidental vascular ligations or nervous injury during surgery were never detected. None of the variables analyzed were statistically significant in predicting the risk of complications, disease-free survival, or overall survival.

Conclusions: IRR represents a rare entity among total relapses. The incidence of complications after salvage ND for IRR is higher than after primary surgery but at an acceptable rate in experienced hands. However, an adequate balance between functional and oncological outcomes is mandatory.

Keywords: head and neck tumors; isolated neck recurrence; salvage neck dissection; salvage surgery; surgical complications.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Chemoradiotherapy / mortality*
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Italy / epidemiology
  • Male
  • Neck Dissection / adverse effects*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Recurrence, Local / therapy*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Complications / pathology
  • Prognosis
  • Retrospective Studies
  • Salvage Therapy / adverse effects*
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Squamous Cell Carcinoma of Head and Neck / surgery
  • Squamous Cell Carcinoma of Head and Neck / therapy*
  • Survival Rate