Efficacy/ Validity of Neck Dissection and Radiotherapy for Cervical Nodal Disease - Clinicopathological Analysis

Abstract

Objective: To analyze treated head and neck malignancies with reference to frequency of cervical metastases and frequency of nodal recurrence following neck dissection and/ or radiotherapy for cervical metastases.Patients and Methods: This observational prospective study was conducted at ENT Department, Pakistan Institute of Medical Sciences, Islamabad over a period of 16 months. Study population was comprised of 15 cases of either gender and any age, with treated head and neck primary who developed metastatic neck disease and were included through non-probability sampling technique. Patients with primary site recurrence or distant metastases were excluded from the study. They were treated with neck dissection, radiotherapy or both for neck disease and followed up for a 1 year. Clinical data including age, gender, site and histopathology of treated primary tumor, nodal involvement both clinical and histopathological, treatment and post treatment result were recorded. Data was collected, tabulated and analyzed using Microsoft excel worksheet.Results: Out of total 15 cases, 17% patients were with N1 disease, 33% patients with N2a disease, and 50% were with N2b disease. Total 3 (20%) patients received radiotherapy (2 being unfit for surgery and 1 due to refused consent) and 12 (80%) patients underwent surgery. Out of these 12, 3 underwent RND, 7 MRND and 2 SND. Total 20% (3) developed recurrence.Conclusion: Combination of RND or MRND and radiotherapy is highly effective in controlling neck disease in controlled primary tumors.