Effectiveness of selective neck dissection for management of the clinically negative neck

Objective: To determine the effectiveness of selective neck dissection for management of the clinically negative neck in head and neck squamous cell carcinoma. Design: A retrospective comparison of patients treated electively with selective neck dissection and comprehensive neck dissection. Setting: Academic tertiary referral center. Patients: Patients with clinically negative necks and previously untreated head and neck squamous cell carcinoma. Intervention: Elective neck dissection, surgical treatment of the primary lesion, and postoperative radio therapy as indicated. Outcome Measures: Regional recurrence, distant metastasis, and disease-free survival. Results: Selective neck dissection was as effective as comprehensive procedures for staging the clinically negative neck. Occult metastases had a statistically significant effect on patient outcome as measured by distant metastasis. Conclusion: Elective neck dissection provides invaluable staging information- which guides the decision for adjuvant therapy.