[Efficacy of radical neck dissection for advanced cervical nodal metastases].

ABSTRACT

OBJECTIVE: To investigate the efficacy of radical neck dissection (RND) to control advanced cervical nodal metastases and analyze the risk factors related with cervical recurrence in head and neck cancer. METHODS: One hundred and twelve patients with N2, N3 head and neck cancer were treated by RND were retrospectively reviewed and the pathological specimen were restudied. RESULTS: Five-year cervical recurrence rate of patients with advanced nodal metastases after RND is 27.7% (31/112), and 16.5% (13/79), 54.5% (18/33) in N2, N3 respectively. The overall 3-year, 5-year survival rate of patients with cervical recurrence after RND was 16.1% (5/31), 9.7% (3/31) respectively. In a univariate chi2 analysis, it was confirmed that the following variables correlated to cervical recurrence, i. e., clinical N staging, size of positive neck nodes, presence of extracapsular nodal spread and invasion of nonlymphatic structures. In a multivariate logistic regression analysis, the most significant risk factor for cervical recurrence was the size of positive neck nodes. CONCLUSIONS: Cervical recurrence is one of the most common reasons for tumor recurrence of head and neck cancer. The size of positive neck nodes is the key risk factor in determining the development of cervical recurrence in patients of advanced cervical nodal metastases after RND. Patients with presence of extracapsular nodal spread and invasion of nonlymphatic structures have high risk of developing cervical recurrence.