The evolving role of selective neck dissection for head and neck squamous cell carcinoma

  title={The evolving role of selective neck dissection for head and neck squamous cell carcinoma},
  author={Kevin Thomas Robbins and Alfio Ferlito and Jatin P. Shah and Marc Hamoir and Robert P. Takes and Primo{\vz} Strojan and Avi Khafif and Carl E. Silver and Alessandra Rinaldo and Jesus E Medina},
  journal={European Archives of Oto-Rhino-Laryngology},
Neck dissection is an important part of the surgical treatment of head and neck squamous cell carcinoma (HNSCC). The historical concept of neck dissection implied the removal of all lymph node-bearing tissue in the neck, which began in the late nineteenth century. However, more conservative variations of neck dissection have been performed and promoted as well. Anatomic, pathologic, clinical investigations, and prospective studies have demonstrated that the lymphatic dissemination of HNSCC… 
Neck management in head and neck squamous cell carcinomas: where do we stand?
The pros and cons related to the different approaches of the neck management in HNSCC are discussed and the approaches and the ensuing outcomes remain not homogenous depending on the centers’ experience, in the context of limited data.
Relevance of Level IIb Neck Dissection in Patients with Head and Neck Squamous Cell Carcinomas
The findings suggest thatlevel IIb neck dissection in patients with head and neck squamous cell carcinomas may be required only if preoperative examination reveals multilevel or level IIa metastasis or suspicious level IIb metastasis.
Radical neck dissection: is it still indicated?
The classic RND has been and is still considered the ‘‘gold standard’’ for the surgical management of lymph node metastases of cancers of the head and neck.
Feasibility of Salvage Selective Neck Dissection after Primary Irradiation of Pharyngeal and Laryngeal Carcinoma
It is well justified to perform a salvage SND (levels II, III, and IV) for pharyngeal and laryngeAl carcinoma after primary radiation in carefully selected cases of supraglottic and oropharyngeAL carcinoma, a superselective ND also appears as an efficient option.
Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma
The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence‐based approach.
Level IIb Neck Dissection in Oral Cavity Cancers- When Should One Address it..?
It is shown that level IIb dissection can be avoided in N0 necks and Level IIb should be cleared if there are positive nodes at level IIa, and there was no statistical association oflevel IIb positivity with stage or site of primary.
Superselective neck dissection: rationale, indications, and results
Evidence from retrospective studies suggests that superselective neck dissection (SSND) is oncologically sound for two indications: elective treatment of the clinically N0 neck and salvage treatment of persistent lymph node disease after chemoradiotherapy.
Indications and outcomes of superselective neck dissection: A review and analysis of the literature
The results of superselective neck dissection when applied to specific settings: the management of regional disease after chemoradiation, head and neck squamous cell carcinoma with clinical N0 necks, and high risk papillary thyroid carcinoma are reported.


Neck dissection: then and now.
Selective Neck Dissection in Node-Positive Squamous Cell Carcinoma of the Head and Neck
  • B. Givi, Gary Linkov, D. Kraus
  • Medicine
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • 2012
In a highly selected group of patients with cervical lymph node metastases from head and neck SCC, selective neck dissection is effective in controlling the disease in the neck when performed in the setting of a multimodality treatment, including adjuvant radiotherapy or radiochemotherapy.
Results of selective neck dissection in management of the node-positive neck.
These results support the use of selective neck dissection in carefully selected patients with clinically node-positive squamous cell carcinoma of the head and neck region, and show regional control rates comparable to those achieved with comprehensive operations can be achieved in appropriately selected patients.
Early history of neck dissection
NECK dissection, for treatment of cervical lymph node metastases in head and neck cancer, was conceived and attempted in the nineteenth century, with some limited success reported by the end of that era and evolved by the mid century into a fundamental tool in the management of patients with head and head cancer.
Neck dissection: past, present and future?
In the future, sentinel lymph node biopsy and the use of molecular pathological analyses may be employed to predict the presence of occult cervical disease, thus directing therapy to patients at greatest risk and sparing those without regional metastasis.
Rationale for selective neck dissection in N+ oral cancer.
The indication of a selective neck dissection including levels I-IV is oncologically safe for SCCs of the inferior mouth when level I is clinically compromised.
Preliminary multi-institutional prospective pathologic and molecular studies support preservation of sublevel IIB and level IV for laryngeal squamous carcinoma with clinically negative neck
Preliminary studies indicate that it is safe and appropriate to eliminate dissection of sublevel IIB and level IV from the elective neck dissection performed for laryngeal cancer with N0 neck, which will reduce both operating time and morbidity, particularly accessory nerve dysfunction, without compromising the oncologic result.
Selective neck dissection for treating node-positive necks in cases of squamous cell carcinoma of the upper aerodigestive tract.
SND may be a good option for treating node-positive necks in selected cases and observed that patients with pharyngeal SCC and older patients presented worse evolution and would probably not be suitable candidates for SND.
The patterns of cervical lymph node metastases from squamous carcinoma of the oral cavity
A retrospective review of the records of 501 previously untreated patients with squamous cell carcinoma of the oral cavity was undertaken to ascertain the prevalence of ipsilateral neck node metastases (NM) by neck level, and data support the trend toward selective limited neck dissection in both NO and N+ patients.