Selective neck dissection as an early salvage intervention for clinically persistent nodal disease following chemoradiation

Background The aim of this study was to determine the efficacy of selective neck dissection (SND) performed for persistent nodal disease after chemoradiation. Methods. Patients treated with definitive chemoradiation for squamous cell carcinoma of the head and neck who subsequently underwent SND for early salvage of clinically persistent nodal disease were evaluated. The primary outcome measure was regional disease control. Results. A total of 62 patients underwent 69 SND procedures. The median time interval between completion of chemoradiation and neck dissection was 10 weeks. There was evidence of residual tumor in 32 neck dissection specimens (46%). Forty patients (65%) remained free of disease, whereas the remaining 22 patients (35%) developed a recurrence, among which 4 were regional. Of these, 3 occurred in the contralateral neck and only 1 occurred in the targeted (ipsilateral) neck. Conclusions. SND is an effective early salvage intervention for persistent nodal disease in patients treated with chemoradiation. (C) 2011 Wiley Periodicals, Inc. Head Neck 34: 188-193, 2012