The extent of neck disease after regional failure during observation of the N 0 neck

Peter Andersen, Efrain Cambronerosan Jose, Ashok R. Shaha, Jatin P. Shah

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

BACKGROUND: The optimum management of the N 0 neck remains controversial. When the neck is observed it is hoped that close follow-up will detect regional failure at an early stage. To test this hypothesis we examined patients undergoing therapeutic neck dissection for newly developed neck metastases during observation after treatment of the primary tumor. METHODS: A retrospective chart review of 47 patients undergoing neck dissection for regional failure after surgical treatment of the primary tumor and observation of the neck from 1987 to 1992 was performed. The median time to failure in the neck was 13 months. RESULTS: The clinical neck stage at the time of neck dissection was N 1 in 37, N(2A) in 6, N(2B) in 1, and N 3 in 3. However, pathologic staging revealed stages of N 1 in 19, N(2A) in 5, N(2B) in 20, and N 3 in 3. Extracapsular spread (ECS) was present in 23 patients (49%). Overall 36 patients (77%) had adverse pathologic findings (N greater than 1 or ECS). CONCLUSIONS: These data indicate that when observation is used for the neck at risk for metastasis, patients tend to fail with high stage disease in the neck. This supports the philosophy of elective treatment of the neck but cannot show whether elective treatment will improve survival.

Original languageEnglish (US)
Pages (from-to)689-691
Number of pages3
JournalAmerican Journal of Surgery
Volume172
Issue number6
DOIs
StatePublished - 1996

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Neck
Observation
Neck Dissection
Neoplasm Metastasis
Therapeutics
Neoplasms
Survival

ASJC Scopus subject areas

  • Surgery

Cite this

The extent of neck disease after regional failure during observation of the N 0 neck. / Andersen, Peter; Jose, Efrain Cambronerosan; Shaha, Ashok R.; Shah, Jatin P.

In: American Journal of Surgery, Vol. 172, No. 6, 1996, p. 689-691.

Research output: Contribution to journalArticle

Andersen, Peter ; Jose, Efrain Cambronerosan ; Shaha, Ashok R. ; Shah, Jatin P. / The extent of neck disease after regional failure during observation of the N 0 neck. In: American Journal of Surgery. 1996 ; Vol. 172, No. 6. pp. 689-691.
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