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International Journal of Otolaryngology
Volume 2012 (2012), Article ID 954203, 5 pages
http://dx.doi.org/10.1155/2012/954203
Research Article

Planned Neck Dissection Following Radiation Treatment for Head and Neck Malignancy

1Division of Otolaryngology-Head and Neck Surgery, University of Calgary, No. 511-505 19th Avenue SW, Calgary, AB, Canada T2S 0E4
2Division of Otolaryngology, Dalhousie University, Halifax, Nova Scotia, Canada B3H 2Y9

Received 3 July 2012; Revised 22 August 2012; Accepted 22 August 2012

Academic Editor: Alexandros D. Karatzanis

Copyright © 2012 J. F. Dautremont et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Optimal therapy for patients with metastatic neck disease remains controversial. Neck dissection following radiotherapy has traditionally been used to improve locoregional control. Methods. A retrospective review of 28 patients with node-positive head and neck malignancy treated with planned neck dissection following radiotherapy between January 2002 and December 2005 was performed to assess treatment outcomes. Results. Median interval to neck dissection was 9.6 weeks with a median number of 21 + 9 lymph nodes per specimen. Ten of 31 (32%) neck dissection specimens demonstrated evidence of residual carcinoma. Overall survival at two years was 85%; five-year overall survival was 65%. Concurrent chemotherapy did not impact the presence of residual neck disease. Conclusion. Based on the frequency of residual malignancy in the neck of patients treated with primary radiotherapy, a planned, postradiotherapy neck dissection should be strongly advocated for all patients with advanced-stage neck disease.