Department of Otolaryngology - Head & Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland.
ENTO Research Unit, College of Medicine and Health, University College, Cork, Ireland.
Head Neck. 2024 Oct;46(10):2464-2472. doi: 10.1002/hed.27727. Epub 2024 Mar 13.
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.
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.
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.
SND can be safely performed in most patients with cN+ SCC, who do not have gross sternocleidomastoid infiltration or level V metastases.
选择性颈部清扫术（SND）传统上应用于黏膜鳞状细胞癌（SCC）的临床阴性（cN0）颈部。我们旨在研究 SND 在临床阳性（cN+）颈部中的肿瘤安全性和区域性复发（RR）模式。
回顾性分析 206 例接受颈部清扫术的黏膜 SCC 患者前瞻性队列研究。RR 分为先前清扫水平内、同侧未清扫水平内、同侧颈部异常位置或对侧颈部。
77 例 cN+患者中有 7 例（9.1%）行 SND 后发生孤立 RR，MRND 后为 16.2%，cN0 疾病行 SND 后为 8.7%。同侧颈部未清扫水平内 RR 少见。RR 和生存率与 cN+或 pN+患者的 ND 范围（SND 与 MRND）无关。
对于没有明显胸锁乳突肌浸润或 V 水平转移的大多数 cN+SCC 患者，可以安全地进行 SND。
