Complications and oncologic outcomes following elective neck dissection with salvage laryngectomy for the N0 neck

Am J Otolaryngol. 2016 May-Jun;37(3):186-94. doi: 10.1016/j.amjoto.2016.01.004. Epub 2016 Jan 22.

Abstract

Purpose: To investigate the difference in survival and complication outcomes between patients with a clinically and radiologically N0 neck who received an elective neck dissection at the time of salvage total laryngectomy compared to those who had salvage total laryngectomy alone.

Materials and methods: A retrospective chart review was performed on 125 salvage total laryngectomy patients who were clinically and radiologically N0 preoperatively. Performance of an elective neck dissection and other factors were tested for associations with various postoperative complications, disease-free survival, and overall survival.

Results: Ninety-eight patients underwent elective neck dissection, of which ten had positive nodal pathology. Elective neck dissection was not significantly associated with complications or survival outcomes. Positive nodal disease was associated with worse disease-free and overall survival on multivariate analysis.

Conclusions: In patients with clinically and radiologically N0 necks undergoing salvage total laryngectomy, an elective neck dissection can provide prognostic information but does not appear to be significantly associated with increased complications or improved survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy*
  • Male
  • Middle Aged
  • Neck Dissection*
  • Neoplasm Staging
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Salvage Therapy*
  • Survival Rate
  • Treatment Outcome