OP129: The role of elective neck dissection during salvage surgery in head and neck squamous cell carcinoma

Abstract

Objective The aim of this study was to evaluate the role of ipsilateral or contralateral elective neck dissection during salvage surgery in head and neck squamous cell carcinoma. Materials and Methods A retrospective study was conducted with total 149 patients who developed a recurrence after primary curative treatment for head and neck squamous cell carcinoma and received salvage surgery for their recurrence. Any dissected neck during previous treatment was excluded in this study. Total 154 node negative and previously un-dissected heminecks were electively dissected or observed. We tried to know the occult metastasis rate in electively dissected group and compared the regional control rate and disease-specific survival rate between elective neck dissection group and observation group. Results Six of 80 electively dissected heminecks (7.5%) had occult nodal metastasis. When comparing regional control rate and disease-specific survival rate between elective neck dissection group and observation group, there was no statistically significant difference between two groups ( p = 0.1902, p = 0.3775, respectively). However, N positive cases at initial treatment and recurrent cases developed within one year had statistically significant advantage when doing elective neck dissection during salvage surgery. Conclusion As occult nodal metastasis ratio is low and there is no statistical benefit of elective neck dissection, elective neck dissection is not always necessary during salvage surgery. However, in patients with N positive at initial treatment and recurrent cases developed within one year, elective neck dissection should be considered during salvage surgery.