gms | German Medical Science

Introduction: Ipsilateral neck dissection represents the therapeutic mainstay in squamous cell carcinomas of the oral cavity and the oropharynx. The necessity of contralateral elective neck dissection is discussed controversially.

Material and methods: The retrospective cohort study included a total of 509 patients who were treated surgically from 2001 to 2015. The cohort was subdivided into patients who underwent ipsi- and bilateral neck dissection. Differences were analysed using Chi square, Fisher exact, and student’s t-test. Survival rates were calculated by Kaplan–Meier and log-rank test. Prognostic variables were subsequently evaluated by Cox regression.

Results: 351 carcinomas were located in the oropharynx comprising 121 T1-, 172 T2-, 50 T3-, and 8 T4-staged tumours. 158 carcinomas were located in the oral cavity including 83 T1-, 54 T2-, 11 T3-, and 10 T4-staged tumours. 257 patients underwent bilateral neck-dissection, 226 patients underwent ipsilateral neck dissection. Comparing the overall and disease specific survival there was no benefit of elective contralateral neck dissection.

Conclusion: There is no general benefit of the bilateral neck dissection in contralateral lymph node negative individuals without taking into consideration the exact degree of laterality of the primary tumor, the T-, and UICC-stage. Longer hospitalization times and therefor higher morbidity seem to play a role in the decision making process as well.

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