Elective radical neck dissection in epidermoid cancer of the head and neck. A retrospective analysis of 853 cases of mouth, pharynx, and larynx cancer

摘要: A retrospective analysis of 853 patients with cancer the mouth, pharynx, and larynx operated on over a 30-year period was performed. Four hundred fifty-seven them had radical neck dissection (RND) at some point. Five ninety no clinically positive nodes (N-o) necks time primary treatment; 99 these elective dissection, whereas 95 others delayed RND when became involved. Twenty-three percent all N-o microscopically involved less than half were among those selected for RND. Furthermore, 58% who did not have nodes. Comparative RND, therapeutic after clinical appearance nodes, composite operations Nl-N3 disease indicates little difference in disease-free survival tumors (56%, 49% 47% respectively). It thus seems that offers real advantage careful watchful waiting approach most patients. Cancer 67:67-71,1991. VER SINCE early anatomic descriptions regional E lymphatic drainage Handley’s work “centrifugal” spread cancer,’ its application by Halstead’ treatment breast cancer, lymphadenectomy performed continuity resection malignant tumor has been traditional oncologic concept. Over years, it applied to practically but more generally accepted epithelial cancers head neck. The concept “elective” node absence palpable (sometimes called “prophylactic” dissection) evolved from our desire remove “en block” together tumor. Recommendations based tendency particular