The role of selective neck dissection in pathological N1 squamous cell carcinomas of the head and neck.

OBJECTIVES: This study aims to evaluate the effectiveness of selective neck dissection (SND) in stage pN1 head and neck cancers. PATIENTS AND METHODS: Patients who underwent neck dissection due to squamous cell carcinoma of oral cavity, larynx, oro-hypopharynx were evaluated retrospectively. Sixty-one patients diagnosed with pathological N1 by neck dissection were included in the study. Thirty-four of the 61 necks, to which SND was applied, comprised the study group, and 27 necks, which underwent comprehensive neck dissection (CND), comprised the control group. RESULTS: Neck recurrence rates were 4.9% for all cases, 5.9% for the SND group and 3.7% for the CND group. Two- and five-year disease-specific survival rates were similar for SND group (78.6%, 72.5%) and CND group (90.5%, 82.9%). Two- and five-year overall survival rates were also similar for SND group (67.6%, 58%) and CND group (81.5%, 66%). None of them were significantly different between groups (p>0.05). CONCLUSION: Selective neck dissection provides comparable results to CND in the treatment of pN1 necks.

[Disclosure of the diagnosis to the patient with head and neck cancer]. / Bas-boyun kanserli hastaya taninin söylenmesi.

OBJECTIVES: The goal of this study was to elicit information on the feelings and thoughts of head and neck cancer patients at the time of disclosure of the diagnosis and to guide the physicians to a better communication with similar patients, taking into consideration general tendencies and the opinion of individual patients. PATIENTS AND METHODS: A questionnaire-based, retrospective study was performed between April 2005 and 2006, including 34 patients (26 males 8 females; mean age 52 years; range 19 to 80 years) with head and neck cancer, who had undergone surgery as primary treatment, had been followed-up for at least two years, and were disease-free at the time of the study. A 30-item questionnaire was administered, consisting of multiple-choice and fill-in-the-blank questions. RESULTS: The diagnosis of cancer was announced to most of the patients in the hospital by the physician. Most recalled the physicians' speech and how they felt, half of them describing depression and fear. The articulation of the informing physician was found very understandable and simple by almost all the patients. Although it was generally thought that the diagnosis had been announced in a comfortable place, taking their privacy into consideration and allocating enough time, 47% expressed their wish for a more friendly and affectionate communication. CONCLUSION: Evaluation of the effects of hearing a malignant diagnosis from the standpoint of a patient with head and neck cancer may make the physician's attitude more solicitous, affectionate, honest, and encouraging, which would further contribute to patient satisfaction and adaptation to treatment.