Complications and oncologic outcomes following elective neck dissection with salvage laryngectomy for the N0 neck

Abstract Purpose To investigate the difference in survival and complication outcomes between patients with a clinically and radiologically N0 neck who received an elective neck dissection at the time of salvage total laryngectomy compared to those who had salvage total laryngectomy alone. Materials...

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Bibliographic Details
Published in:American journal of otolaryngology 2016-05, Vol.37 (3), p.186-194
Main Authors: Freiser, Monika E., MD, MPH, Ojo, Rosemary B., MD, Lo, Kaming, MPH, Saint-Victor, Sandra, MD, Bollig, Craig, MD, Nayak, Chetan S., MD, Sargi, Zoukaa B., MD, MPH
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Aged, 80 and over
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Clinical outcomes
Disease-Free Survival
Dissection
Female
Humans
Infections
Laryngeal Neoplasms - mortality
Laryngeal Neoplasms - pathology
Laryngeal Neoplasms - surgery
Laryngectomy
Larynx
Logistics
Male
Middle Aged
Mortality
Neck Dissection
Neoplasm Staging
Occult sciences
Otolaryngology
Pathology
Postoperative Complications - epidemiology
Radiation therapy
Retrospective Studies
Salvage
Salvage Therapy
Surgery
Survival Rate
Treatment Outcome
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Summary:Abstract Purpose To investigate the difference in survival and complication outcomes between patients with a clinically and radiologically N0 neck who received an elective neck dissection at the time of salvage total laryngectomy compared to those who had salvage total laryngectomy alone. Materials and methods A retrospective chart review was performed on 125 salvage total laryngectomy patients who were clinically and radiologically N0 preoperatively. Performance of an elective neck dissection and other factors were tested for associations with various postoperative complications, disease-free survival, and overall survival. Results Ninety-eight patients underwent elective neck dissection, of which ten had positive nodal pathology. Elective neck dissection was not significantly associated with complications or survival outcomes. Positive nodal disease was associated with worse disease-free and overall survival on multivariate analysis. Conclusions In patients with clinically and radiologically N0 necks undergoing salvage total laryngectomy, an elective neck dissection can provide prognostic information but does not appear to be significantly associated with increased complications or improved survival.
ISSN:0196-0709
1532-818X
DOI:10.1016/j.amjoto.2016.01.004