Pattern of regional recurrence after selective neck dissection for clinically positive neck in mucosal squamous carcinoma

Mohammad Altawil; Isabella Stanisz; Nadia H Van Den Berg; Patrick Sheahan

doi:10.1002/hed.27727

Pattern of regional recurrence after selective neck dissection for clinically positive neck in mucosal squamous carcinoma

Head Neck. 2024 Mar 13. doi: 10.1002/hed.27727. Online ahead of print.

Authors

Mohammad Altawil¹, Isabella Stanisz¹, Nadia H Van Den Berg¹, Patrick Sheahan^{1

2}

Affiliations

¹ Department of Otolaryngology - Head & Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland.
² ENTO Research Unit, College of Medicine and Health, University College, Cork, Ireland.

PMID: 38476090
DOI: 10.1002/hed.27727

Abstract

Background: Selective neck dissection (SND) has traditionally been applied to clinically negative (cN0) necks in mucosal squamous cell carcinoma (SCC). We aimed to examine the oncological safety and patterns of regional recurrence (RR) of SND in clinically positive (cN+) necks.

Methods: Retrospective review of prospective cohort of 206 patients with mucosal SCC undergoing neck dissection. RR was classified as occurring within previously dissected levels, within ipsilateral undissected levels, within unusual locations of ipsilateral neck, or contralateral neck.

Results: Seven of seventy-seven (9.1%) cN+ patients undergoing SND developed isolated RR, versus 16.2% after MRND, and 8.7% after SND for cN0 disease. RR was rarely seen within undissected levels of the ipsilateral neck. RR and survival rates were not associated with ND extent (SND vs. MRND) among either cN+ or pN+ patients.

Conclusion: SND can be safely performed in most patients with cN+ SCC, who do not have gross sternocleidomastoid infiltration or level V metastases.

Keywords: neck dissection; recurrence; selective neck dissection; squamous cell carcinoma.