Conversion from Selective to Comprehensive Neck Dissection: Is It Necessary for Occult Nodal Metastasis? 5-Year Observational Study
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Objectives. To compare the therapeutic results between selective neck dissection (SND) and conversion modified radicalneck dissection (MRND) for the occult nodal metastasis cases in head and neck squamous cell carcinoma. Methods. Forty-four cases with occult nodal metastasis were enrolled in this observational cohort study. For twenty-ninecases, SNDs were done and for fifteen cases, as metastatic nodes were found in the operative field, conversion fromselective to MRNDs type II were done. Baseline data on primary site, T and N stage, extent of SND, extracapsularspread of occult metastatic node and type of postoperative adjuvant therapy were obtained. We compared locoregionalcontrol rate, overall survival rate and disease specific survival rate between two groups. Results. Among the 29 patients who underwent SND, only one patient had a nodal recurrence which occurred in the contralateralundissected neck. On the other hand, among the 15 patients who underwent conversion MRND, two patientshad nodal recurrences which occurred in previously undissected neck. According to the Kaplan Meier survivalcurve, there was no statistically significant difference for locoregional control rate, overall survival rate and diseasespecific survival rate between two groups (P=0.2719, P=0.7596, and P=0.2405, respectively). Conclusion. SND is enough to treat occult nodal metastasis in head and neck squamous cell carcinoma and it is not necessaryto convert from SND to comprehensive neck dissection.
Abstract
Objectives. To compare the therapeutic results between selective neck dissection (SND) and conversion modified radicalneck dissection (MRND) for the occult nodal metastasis cases in head and neck squamous cell carcinoma. Methods. Forty-four cases with occult nodal metastasis were enrolled in this observational cohort study. For twenty-ninecases, SNDs were done and for fifteen cases, as metastatic nodes were found in the operative field, conversion fromselective to MRNDs type II were done. Baseline data on primary site, T and N stage, extent of SND, extracapsularspread of occult metastatic node and type of postoperative adjuvant therapy were obtained. We compared locoregionalcontrol rate, overall survival rate and disease specific survival rate between two groups. Results. Among the 29 patients who underwent SND, only one patient had a nodal recurrence which occurred in the contralateralundissected neck. On the other hand, among the 15 patients who underwent conversion MRND, two patientshad nodal recurrences which occurred in previously undissected neck. According to the Kaplan Meier survivalcurve, there was no statistically significant difference for locoregional control rate, overall survival rate and diseasespecific survival rate between two groups (P=0.2719, P=0.7596, and P=0.2405, respectively). Conclusion. SND is enough to treat occult nodal metastasis in head and neck squamous cell carcinoma and it is not necessaryto convert from SND to comprehensive neck dissection.
참고문헌 (13)
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