Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: SND can be safely performed in most patients with cN+ SCC, who do not have gross sternocleidomastoid infiltration or level V metastases.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: SND can be safely performed in most patients with cN+ SCC, who do not have gross sternocleidomastoid infiltration or level V metastases.
摘要：
背景：选择性颈清扫术（SND）传统上已应用于粘膜鳞状细胞癌（SCC）的临床阴性（cN0）颈部。我们旨在检查临床阳性（cN）颈部SND的肿瘤学安全性和区域复发（RR）模式。
方法：回顾性分析了206例粘膜SCC患者行颈部清扫术的前瞻性队列。RR被分类为发生在先前解剖的水平内，在同侧未解剖水平内，在同侧颈部的不寻常位置，或对侧颈部。
结果：77例（9.1％）接受SND的cN+患者中有7例出现了孤立的RR，与MRND后的16.2%相比，为cN0病SND后8.7%。在同侧颈部的未解剖水平内很少见到RR。RR和生存率与ND程度无关(SND与MRND)在cN+或pN+患者中。
结论：在大多数cN+SCC患者中可以安全地进行SND，没有明显的胸锁乳突样浸润或V级转移。
方法：回顾性分析了206例粘膜SCC患者行颈部清扫术的前瞻性队列。RR被分类为发生在先前解剖的水平内，在同侧未解剖水平内，在同侧颈部的不寻常位置，或对侧颈部。
结果：77例（9.1％）接受SND的cN+患者中有7例出现了孤立的RR，与MRND后的16.2%相比，为cN0病SND后8.7%。在同侧颈部的未解剖水平内很少见到RR。RR和生存率与ND程度无关(SND与MRND)在cN+或pN+患者中。
结论：在大多数cN+SCC患者中可以安全地进行SND，没有明显的胸锁乳突样浸润或V级转移。
