Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma

Head Neck. 2015 Jun;37(6):915-26. doi: 10.1002/hed.23689. Epub 2014 Jun 30.

Abstract

Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach.

Keywords: clinically negative neck; clinically positive neck; head and neck squamous cell carcinoma; neck dissection; neck metastasis.

Publication types

  • Review

MeSH terms

  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / surgery*
  • Disease-Free Survival
  • Evidence-Based Medicine
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Lymph Node Excision / methods
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery*
  • Lymphatic Metastasis
  • Male
  • Neck Dissection / methods*
  • Neck Dissection / mortality
  • Prognosis
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome