Effectiveness of Selective Neck Dissection for Management of the Clinically Negative Neck

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Abstract
Objective: To determine the effectiveness of selective neck dissection for management of the clinically negative neck in head and neck squamous cell carcinoma. Design: A retrospective comparison of patients treated electively with selective neck dissection and comprehensive neck dissection. Setting: Academic tertiary referral center. Patients: Patients with clinically negative necks and previously untreated head and neck squamous cell carcinoma. Intervention: Elective neck dissection, surgical treatment of the primary lesion, and postoperative radiotherapy as indicated. Outcome Measures: Regional recurrence, distant metastasis, and disease-free survival. Results: Selective neck dissection was as effective as comprehensive procedures for staging the clinically negative neck. Occult metastases had a statistically significant effect on patient outcome as measured by distant metastasis. Conclusion: Elective neck dissection provides invaluable staging information, which guides the decision for adjuvant therapy. Arch Otolaryngol Head Neck Surg. 1997;123:917-922