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

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Robbins, K Thomas Ferlito, Alfio Shah, Jatin P. Hamoir, Marc [UCL] Takes, Robert P. Medina, Jesus E.

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 occurs in predictable patterns. Supported by these studies, selective neck dissection (SND), which consists of the removal of select levels of lymph nodes in the neck that have the highest risk of harboring undetected metastases, has become widely accepted in the treatment of the clinically uninvolved neck. More recently, evidence supports using SND in a therapeutic setting in selected cases of HNSCC with limited metastatic disease. Additionally, even more targeted dissections referred to as super-selective neck dissection have been explored for selected patients undergoing elective node dissection for supraglottic cancer and as an adjuvant therapy for salvage of residual lymphadenopathy confined to a single neck level following chemoradiation. In the future, the trend to tailor treatment to individual patients and to limit toxicity and morbidity may further increase the use of SND. The indications have to be guided by further research, in relation with non-surgical treatment options while optimizing oncological effectiveness.

Document type Article de périodique (Journal article) – Synthèse de littérature
Access type Accès restreint
Publication date 2013
Language Anglais
Journal information "European Archives of Oto-Rhino-Laryngology" - Vol. 270, no.4, p. 1195-1202 (2012)
Peer reviewed yes
Publisher Springer ((Germany) Heidelberg)
issn 0937-4477
e-issn 1434-4726
Publication status Publié
Affiliations UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie
UCL - (SLuc) Service d'oto-rhino-laryngologie
UCL - (SLuc) Centre du cancer
MESH Subject Carcinoma, Squamous Cell ; Risk ; Salvage Therapy ; Treatment Outcome ; Chemotherapy, Adjuvant ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Neck Dissection ; Neoplasm, Residual ; Otorhinolaryngologic Neoplasms ; Radiotherapy, Adjuvant
Keywords Head and neck ; Squamous cell carcinoma ; Selective neck dissection ; Elective neck dissection ; Therapeutic neck dissection
Links
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Bibliographic reference Robbins, K Thomas ; Ferlito, Alfio ; Shah, Jatin P. ; Hamoir, Marc ; Takes, Robert P. ; et. al. The evolving role of selective neck dissection for head and neck squamous cell carcinoma. In: European Archives of Oto-Rhino-Laryngology, Vol. 270, no.4, p. 1195-1202 (2012)
Permanent URL http://hdl.handle.net/2078.1/156870