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In patients with metastatic cutaneous head and neck squamous cell carcinoma to cervical lymph nodes, the extent of neck dissection does not influence outcome

Published online by Cambridge University Press:  09 October 2012

J T Wang ,
C E Palme ,
A Y Wang ,
G J Morgan ,
V Gebski  and
M J Veness
J T Wang
Affiliation:
Head and Neck Cancer Service, Westmead Hospital, Australia
C E Palme
Affiliation:
Head and Neck Cancer Service, Westmead Hospital, Australia
A Y Wang
Affiliation:
Head and Neck Cancer Service, Westmead Hospital, Australia
G J Morgan
Affiliation:
Head and Neck Cancer Service, Westmead Hospital, Australia
V Gebski
Affiliation:
Head and Neck Cancer Service, Westmead Hospital, Australia National Health and Medical Research Council Clinical Trials Centre, University of Sydney, New South Wales, Australia
M J Veness*
Affiliation:
Head and Neck Cancer Service, Westmead Hospital, Australia
*
Address for correspondence: A/Prof Michael J Veness, Radiation Oncologist, Staff Specialist, Department of Radiation Oncology, Westmead Hospital, Westmead, Sydney, NSW, Australia2145 Fax: +61 2 9891 5814 E-mail: michael.veness@swahs.health.nsw.gov.au
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Abstract

Background:

This study aimed to compare recurrence and survival in patients undergoing either selective neck dissection or modified radical neck dissection to treat metastatic cutaneous head and neck squamous cell carcinoma to the cervical lymph nodes (levels I–V) only.

Methods:

Twenty-eight year, retrospective analysis of a prospectively maintained database from a tertiary referral hospital, with a minimum follow up of two years.

Results:

There were 122 eligible patients: 96 males (79 per cent) and 26 (21 per cent) females (median age, 66 years). Sixty-six patients (54 per cent) underwent selective neck dissection and 56 (46 per cent) modified radical neck dissection. The former patients had a lower rate of regional recurrence compared with the latter (17 vs 23 per cent, respectively). There was no significant difference in five-year overall survival (61 vs 57 per cent, respectively) or five-year disease-free survival (74 vs 60 per cent, respectively), comparing the two groups. Overall survival and disease-free survival were significantly improved by the addition of adjuvant radiotherapy.

Conclusion:

We found no difference in outcome in patients undergoing selective versus modified radical neck dissection. Adjuvant radiotherapy significantly improved outcome.

Keywords

Head And NeckCutaneous Squamous Cell CarcinomaNodal MetastasesNeck DissectionSurgery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Supplement S1 , January 2013 , pp. S2 - S7
Copyright
Copyright © JLO (1984) Limited 2012

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Footnotes

Presented orally at the Australian Society of Head and Neck Surgery Annual Scientific Meeting, 5 April 2011, Melbourne, Victoria, Australia

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