Objective: To determine the effectiveness of selective neck dissection for management of the clinically negative neck in head and neck squamous cell carcinoma.
Design: A retrospective comparison of patients treated electively with selective neck dissection and comprehensive neck dissection.
Setting: Academic tertiary referral center.
Patients: Patients with clinically negative necks and previously untreated head and neck squamous cell carcinoma.
Intervention: Elective neck dissection, surgical treatment of the primary lesion, and postoperative radiotherapy as indicated.
Outcome measures: Regional recurrence, distant metastasis, and disease-free survival.
Results: Selective neck dissection was as effective as comprehensive procedures for staging the clinically negative neck. Occult metastases had a statistically significant effect on patient outcome as measured by distant metastasis.
Conclusion: Elective neck dissection provides invaluable staging information, which guides the decision for adjuvant therapy.