Efficacy of super-selective neck dissection following chemoradiation for advanced head and neck cancer

Background: Hypothesizing that neck-level specific locations of residual lymph node metastases following chemoradiation for head and neck cancer are highly predictable, the efficacy of the more targeted lymphadenectomy procedure called super-selective neck dissection (SSND) was evaluated. Methods: A retrospective analysis of the databases from 2 institutions indicated that 35 SSND's were performed on 30 patients following chemoradiation as either a planned or early salvage intervention. Results: Over a median follow-up of 33 (range: 8-72) months, 8 patients developed recurrent disease (3 primary, 5 distant) but there were no isolated recurrences in the neck. The projected 5 year disease specific survival rate for the group was 60%. Conclusions: SSND is an effective intervention for patients with advanced head and neck cancer treated with chemoradiation whose risk for residual nodal disease is confined to one level. (C) 2012 Elsevier Ltd. All rights reserved.