Extent of salvage neck dissection for residual or recurrent cervical nodal disease

J Laryngol Otol. 2025 Feb;139(2):141-145. doi: 10.1017/S0022215124001452. Epub 2024 Oct 21.

Abstract

Objectives: Salvage neck dissection for squamous cell carcinoma is performed for residual or recurrent nodal disease after chemoradiotherapy or radical radiotherapy for locally advanced head and neck cancer. Our study aims to investigate the extent to which salvage neck dissection can be safely performed in treating recurrent or residual nodal metastasis.

Methods: A retrospective analysis of 53 patients with suspected residual or recurrent nodal disease after primary treatment (January 2016 to December 2018) was performed.

Results: Pathological confirmation of viable squamous cell carcinoma following surgery was found in 43.4 per cent of patients. Post-operative infection, accessory and vagal nerve injuries were more common in patients with dissection of levels I-V than that of levels II-IV. There was no significant difference in three-year survival rate between patients with levels II-IV dissection and that of levels I-V dissection (p = 0.84).

Conclusion: The extent of salvage neck dissection can be limited to reduce post-operative complications while maintaining acceptable oncological outcomes.

Keywords: chemo-radiotherapy; head and neck cancer; neck lump; oropharyngeal neoplasm; radiotherapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Female
  • Head and Neck Neoplasms* / mortality
  • Head and Neck Neoplasms* / pathology
  • Head and Neck Neoplasms* / surgery
  • Humans
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neck Dissection* / adverse effects
  • Neck Dissection* / methods
  • Neoplasm Recurrence, Local* / mortality
  • Neoplasm Recurrence, Local* / pathology
  • Neoplasm Recurrence, Local* / surgery
  • Neoplasm, Residual / surgery
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Salvage Therapy* / methods
  • Squamous Cell Carcinoma of Head and Neck* / mortality
  • Squamous Cell Carcinoma of Head and Neck* / pathology
  • Squamous Cell Carcinoma of Head and Neck* / surgery
  • Treatment Outcome