gms | German Medical Science

Introduction: Selective neck dissection in clinically node negative neck is considered to be the standard of care for Oral Squamous Cell Carcinomas (OSCC). Controversy still prevails in node positive disease regarding extent of neck clearance. In our part of the world, comprehensive neck dissection is considered as minimal optimal treatment for palpable neck disease. We intend to assess the role of Selective Neck Dissection in patients with clinically positive nodes at levels I-IV, in terms of regional disease control and/or diminished survival.

Material and methods: This was a Retrospective study conducted in the Department of ENT Head and neck surgery Patel Hospital Karachi. All patients with biopsy proven OSCC that underwent selective neck dissection, between April 2006 and July 2015 were included in the study.

Results: 124 patients with OSCC included. Mean age was 47 years, with over 70% male patients. Of them 77 (62%) were clinically node negative and 47 (38%) patients had clinically positive nodes in the neck. The mean follow-up was 18 months (SD=19). The overall regional control rates were 95% vs. 96% for clinical negative vs. positive nodes, respectively (P=0.589). The overall survival was 83% in Node negative group vs. 70% in node positive disease (P=0.73).

Conclusion: Selective neck dissection in neck positive OSCC has similar regional control rates, when compared to node negative SCC. The difference in Overall survival between the two groups is also not significant. Therefore, we suggest that selective neck dissection can be done in selected patients of oral SCC with palpable neck disease.

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