Extent of salvage neck dissection for residual or recurrent cervical nodal disease

Abstract

Objectives Salvage neck dissection for squamous cell carcinoma is performed for residual or recurrent nodal disease after chemoradiotherapy or radical radiotherapy for locally advanced head and neck cancer. Our study aims to investigate the extent to which salvage neck dissection can be safely performed in treating recurrent or residual nodal metastasis. Methods A retrospective analysis of 53 patients with suspected residual or recurrent nodal disease after primary treatment (January 2016 to December 2018) was performed. Results Pathological confirmation of viable squamous cell carcinoma following surgery was found in 43.4 per cent of patients. Post-operative infection, accessory and vagal nerve injuries were more common in patients with dissection of levels I-V than that of levels II-IV. There was no significant difference in three-year survival rate between patients with levels II-IV dissection and that of levels I-V dissection (p = 0.84). Conclusion The extent of salvage neck dissection can be limited to reduce post-operative complications while maintaining acceptable oncological outcomes.