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Kyung Tae - One of the best experts on this subject based on the ideXlab platform.
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Transoral robotic Selective Neck Dissection for papillary thyroid carcinoma: Dissection of Levels III and IV.
Head & neck, 2020Co-Authors: Kyung Tae, Keon-ho KimAbstract:We present the operative procedure of transoral robotic Selective Neck Dissection for papillary thyroid carcinoma. A 28-year-old woman, diagnosed with papillary thyroid carcinoma and lymph node metastasis at right level IV, underwent total thyroidectomy, central Neck Dissection, and Selective Neck Dissection involving levels III and IV via the transoral robotic approach. A 1.5-2-cm central incision was made near the base of the lower lip frenulum, and two lateral incisions were made close to the oral commissure. An additional right axillary port was made to place a third robotic instrument for counter-traction. The operation was completed successfully without conversion to the conventional transcervical approach. The working space and surgical view were enough to perform Selective Neck Dissection of levels III and IV. There were no major postoperative complications. Transoral robotic Selective Neck Dissection of levels III and IV is feasible and safe in selected patients.
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comparison of robotic versus conventional Selective Neck Dissection and total thyroidectomy for papillary thyroid carcinoma
Otolaryngology-Head and Neck Surgery, 2016Co-Authors: Chang Myeon Song, Eui Suk Sung, Dong Sun Kim, Hye Ryoung Koo, Kyung TaeAbstract:ObjectiveTo compare the surgical outcomes of robotic Selective Neck Dissection (SND) with total thyroidectomy and conventional transcervical SND with total thyroidectomy.Study DesignCase series with chart review.SettingUniversity tertiary care facility.Subject and MethodsWe retrospectively analyzed 66 patients who underwent total thyroidectomy with SND (≥3 levels of II-V) and bilateral central Neck Dissection for cN1b papillary thyroid carcinoma, of whom 41 underwent conventional SND and 25 of whom underwent robotic SND. Subjective pain, sensory change, and cosmetic satisfaction were evaluated regularly for 3 months with a questionnaire.ResultsCompared with the conventional group, patients in the robotic group were younger (mean, 36.7 vs 47.5 years; P = .003) and more female dominant (96.0% vs 73.2%; P = .023). Mean total operative time was longer in the robotic group than the conventional group (298 vs 236 minutes; P < .001). Anterior chest pain was higher in the robotic group at postoperative 1 day (pai...
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Feasibility of Charcoal Tattooing for Localization of Metastatic Lymph Nodes in Robotic Selective Neck Dissection for Papillary Thyroid Carcinoma.
Annals of Surgical Oncology, 2015Co-Authors: Chang Myeon Song, Jeong Seon Park, Woosung Park, Seok Hyun Cho, Kyung TaeAbstract:Background This study aimed to evaluate the feasibility and effectiveness of ultrasound-guided charcoal tattooing in locating metastatic lymph nodes in robotic Selective Neck Dissection (SND) for papillary thyroid carcinoma (PTC).
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robotic Selective Neck Dissection by a postauricular facelift approach comparison with conventional Neck Dissection
Otolaryngology-Head and Neck Surgery, 2014Co-Authors: Kyung Tae, Chang Myeon Song, Seok Hyun Cho, Jin Hyeok Jeong, Seung Hwan LeeAbstract:ObjectivesThe aim of this study was to investigate the feasibility and efficacy of robot-assisted Neck Dissection by a postauricular facelift approach in head and Neck squamous cell carcinoma (HNSCC), compared with conventional Neck Dissection.Study DesignCase series with chart review.SettingUniversity tertiary care hospital.Subjects and MethodsThirty HNSCC patients with clinically node negative Necks (cN0) who underwent robot-assisted Selective Neck Dissection (SND) by a postauricular facelift approach (11 patients, 12 Necks) or conventional Neck Dissection (19 patients, 21 Necks).ResultsThe mean age was lower in the robotic group (P = .030). However, the distributions of gender and TNM stage did not differ between the two groups. The robotic SND was completed successfully in all patients. The mean operative time was longer in the robotic group (215 ± 56 min) than the conventional group (144 ± 43 min) (P < .001). The mean numbers of lymph nodes removed were 25.0 ± 7.4 and 28.9 ± 8.2 in the robotic and co...
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Robotic Selective Neck Dissection using a gasless postauricular facelift approach for early head and Neck cancer: technical feasibility and safety.
Journal of laparoendoscopic & advanced surgical techniques. Part A, 2013Co-Authors: Kyung Tae, Chang Myeon Song, Hyun Jung Min, Kyung Rae Kim, Chul Won ParkAbstract:Abstract Background: Scarless and minimally invasive surgery is becoming popular in the head and Neck area. We have developed a new robotic Selective Neck Dissection procedure for head and Neck squamous cell carcinoma (HNSCC) to avoid a long visible lateral Neck scar. Here we report on the technical feasibility and safety of our procedure. Subjects and Methods: We prospectively analyzed 4 patients with early HNSCC who underwent transoral robotic surgery (TORS) and concomitant robotic Selective Neck Dissection via a gasless postauricular facelift approach using the da Vinci® Surgical System (Intuitive Surgical Inc., Sunnyvale, CA). Results: Of these patients, 3 were male, and 1 was female. The mean age was 59.0±8.8 years. All patients had tongue cancer, with a clinically negative Neck. Three patients were T1, and 1 patient was T2. All patients underwent partial glossectomy by TORS and elective robotic Selective Neck Dissection including levels I, II, and III. The robotic Selective Neck Dissection procedure...
K. Thomas Robbins - One of the best experts on this subject based on the ideXlab platform.
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The Evolving Role of Selective Neck Dissection for Head and Neck Squamous Cell Carcinoma
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated wi, 2012Co-Authors: K. Thomas Robbins, Alfio Ferlito, Alessandra Rinaldo, Carl E. Silver, Jatin P. Shah, Robert P. Takes, Marc Hamoir, Primož Strojan, Avi Khafif, Jesus E. MedinaAbstract:Neck Dissection is an important part of the surgical treatment of head and Neck squamous cell carcinoma (HNSCC). The historical concept of Neck Dissection implied the removal of all lymph node-bearing tissue in the Neck, which began in the late nineteenth century. However, more conservative variations of Neck Dissection have been performed and promoted as well. Anatomic, pathologic, clinical investigations, and prospective studies have demonstrated that the lymphatic dissemination of HNSCC occurs in predictable patterns. Supported by these studies, Selective Neck Dissection (SND), which consists of the removal of select levels of lymph nodes in the Neck that have the highest risk of harboring undetected metastases, has become widely accepted in the treatment of the clinically uninvolved Neck. More recently, evidence supports using SND in a therapeutic setting in selected cases of HNSCC with limited metastatic disease. Additionally, even more targeted Dissections referred to as super-Selective Neck Dissection have been explored for selected patients undergoing elective node Dissection for supraglottic cancer and as an adjuvant therapy for salvage of residual lymphadenopathy confined to a single Neck level following chemoradiation. In the future, the trend to tailor treatment to individual patients and to limit toxicity and morbidity may further increase the use of SND. The indications have to be guided by further research, in relation with non-surgical treatment options while optimizing oncological effectiveness.
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Efficacy of super-Selective Neck Dissection following chemoradiation for advanced head and Neck cancer
Oral oncology, 2012Co-Authors: K. Thomas Robbins, Muthuswamy Dhiwakar, Krishna Rao, Francisco Vieira, James MaloneAbstract:Summary Background Hypothesizing that Neck-level specific locations of residual lymph node metastases following chemoradiation for head and Neck cancer are highly predictable, the efficacy of the more targeted lymphadenectomy procedure called super-Selective Neck Dissection (SSND) was evaluated. Methods A retrospective analysis of the databases from 2 institutions indicated that 35 SSND’s were performed on 30 patients following chemoradiation as either a planned or early salvage intervention. Results Over a median follow-up of 33 (range: 8–72) months, 8 patients developed recurrent disease (3 primary, 5 distant) but there were no isolated recurrences in the Neck. The projected 5 year disease specific survival rate for the group was 60%. Conclusions SSND is an effective intervention for patients with advanced head and Neck cancer treated with chemoradiation whose risk for residual nodal disease is confined to one level.
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Efficacy of Selective Neck Dissection for nodal metastasis with involvement of nonlymphatic structures.
Head & neck, 2010Co-Authors: Muthuswamy Dhiwakar, K. Thomas Robbins, Krishna Rao, Francisco Vieira, James MaloneAbstract:Background. Our aim in carrying out this study was to determine the efficacy of Selective Neck Dissection (SND) for cervical metastases with clinical involvement of adjacent nonlymphatic structures. Methods. In all, 39 patients were retrospectively analyzed with respect to 43 extended Selective Neck Dissection (ESND) procedures. Results. Eighteen procedures were performed as part of the primary treatment and 25 for salvage following (chemo)radiation. Although most patients (84%) had nodal disease ≥N2, 91% had disease clinically confined to ≤2 Neck levels. SND (levels II–IV) was most commonly performed and the internal jugular vein was the nonlymphatic structure most often sacrificed. Recurrence rate in the ipsilateral targeted Neck was 0% and 13% in the primary surgery and postradiation groups, respectively. Conclusions. SND that is extended to include adjacent nonlymphatic structures appears to be effective for advanced nodal metastasis confined to ≤2 nodal levels. We support the use of the term “extended Selective Neck Dissection (ESND)” to describe this modification of Neck Dissection. © 2010 Wiley Periodicals, Inc. Head Neck, 2011
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Effectiveness of SuperSelective and Selective Neck Dissection for Advanced Nodal Metastases After Chemoradiation
Archives of otolaryngology--head & neck surgery, 2005Co-Authors: K. Thomas Robbins, Sandeep Samant, Ilana Doweck, Francisco VieiraAbstract:Objective: To determine the efficacy of Selective and superSelective Neck Dissection for patients with bulky or residual nodal metastasis treated with concomitant intra-arterial cisplatin and radiotherapy. Design: Prospective study. Setting: University of Tennessee, Memphis. Patients: A total of 240 patients with stage III or IV head and Neck squamous cell carcinoma. Interventions: Treatment with cisplatin, 150 mg/m 2 intra-arterially, and sodium thiosulfate, 9 g/m 2 intravenously, weekly for 4 weeks; and radiotherapy, 2 Gy per fraction per day, 5 times weekly, for a total of 68 to 74Gy over 6 to 7 weeks. Main Outcome Measures: Regional control, distant metastases, and overall survival for patients undergoing radical or modified radical Neck Dissection (n=12), Selective Neck Dissection (n=65), and superSelective Neck Dissection (levels II-III only) (n=7). Results: Among the total group of 240 patients, 106 Neck Dissections were performed on 84 patients who had bulky nodal disease. With a median follow-up of 58 months (range, 12-96 months), regional failure occurred in 11 (4.6%) of 240 patients: 2 (17%) of the 12 who had modified radical Neck Dissection, 3 (5%) of the 65 who had Selective Neck Dissection, none of the 7 patients who had superSelective Neck Dissection, and 6 (4%) of the 156 who had no Neck Dissection. The rates of overall survival and distant metastases were not significantly different among the 3 Neck Dissection subsets. Conclusion: Selective and superSelective Neck Dissection, which spare function and minimize morbidity, are viable therapeutic alternatives for patients with residual disease confined to 1 level after intra-arterial chemoradiation treatment, and possibly for other chemoradiation protocols.
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Elective and therapeutic Selective Neck Dissection.
Oral oncology, 2005Co-Authors: Alfio Ferlito, Ashok R Shaha, Alessandra Rinaldo, Carl E. Silver, Christine G. Gourin, Jatin P. Shah, Gary L. Clayman, Luiz P. Kowalski, K. Thomas Robbins, Carlos SuárezAbstract:Selective Neck Dissection is a modification of the more comprehensive modified radical or radical Neck Dissection that is designed to remove only those nodal levels considered to be at risk for harboring nodal metastases. The role of Selective Neck Dissection continues to evolve: while initially designed as a staging and diagnostic procedure for patients without clinical evidence of nodal disease, a growing body of literature suggests that Selective Neck Dissection has a therapeutic role in patients with clinical and histologic evidence of nodal metastases. The rationale behind Selective Neck Dissection, its application in the clinically negative but histologically node-positive Neck and the extended application of Selective Neck Dissection in patients with clinical evidence of nodal disease are discussed.
Chang Myeon Song - One of the best experts on this subject based on the ideXlab platform.
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comparison of robotic versus conventional Selective Neck Dissection and total thyroidectomy for papillary thyroid carcinoma
Otolaryngology-Head and Neck Surgery, 2016Co-Authors: Chang Myeon Song, Eui Suk Sung, Dong Sun Kim, Hye Ryoung Koo, Kyung TaeAbstract:ObjectiveTo compare the surgical outcomes of robotic Selective Neck Dissection (SND) with total thyroidectomy and conventional transcervical SND with total thyroidectomy.Study DesignCase series with chart review.SettingUniversity tertiary care facility.Subject and MethodsWe retrospectively analyzed 66 patients who underwent total thyroidectomy with SND (≥3 levels of II-V) and bilateral central Neck Dissection for cN1b papillary thyroid carcinoma, of whom 41 underwent conventional SND and 25 of whom underwent robotic SND. Subjective pain, sensory change, and cosmetic satisfaction were evaluated regularly for 3 months with a questionnaire.ResultsCompared with the conventional group, patients in the robotic group were younger (mean, 36.7 vs 47.5 years; P = .003) and more female dominant (96.0% vs 73.2%; P = .023). Mean total operative time was longer in the robotic group than the conventional group (298 vs 236 minutes; P < .001). Anterior chest pain was higher in the robotic group at postoperative 1 day (pai...
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Feasibility of Charcoal Tattooing for Localization of Metastatic Lymph Nodes in Robotic Selective Neck Dissection for Papillary Thyroid Carcinoma.
Annals of Surgical Oncology, 2015Co-Authors: Chang Myeon Song, Jeong Seon Park, Woosung Park, Seok Hyun Cho, Kyung TaeAbstract:Background This study aimed to evaluate the feasibility and effectiveness of ultrasound-guided charcoal tattooing in locating metastatic lymph nodes in robotic Selective Neck Dissection (SND) for papillary thyroid carcinoma (PTC).
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robotic Selective Neck Dissection by a postauricular facelift approach comparison with conventional Neck Dissection
Otolaryngology-Head and Neck Surgery, 2014Co-Authors: Kyung Tae, Chang Myeon Song, Seok Hyun Cho, Jin Hyeok Jeong, Seung Hwan LeeAbstract:ObjectivesThe aim of this study was to investigate the feasibility and efficacy of robot-assisted Neck Dissection by a postauricular facelift approach in head and Neck squamous cell carcinoma (HNSCC), compared with conventional Neck Dissection.Study DesignCase series with chart review.SettingUniversity tertiary care hospital.Subjects and MethodsThirty HNSCC patients with clinically node negative Necks (cN0) who underwent robot-assisted Selective Neck Dissection (SND) by a postauricular facelift approach (11 patients, 12 Necks) or conventional Neck Dissection (19 patients, 21 Necks).ResultsThe mean age was lower in the robotic group (P = .030). However, the distributions of gender and TNM stage did not differ between the two groups. The robotic SND was completed successfully in all patients. The mean operative time was longer in the robotic group (215 ± 56 min) than the conventional group (144 ± 43 min) (P < .001). The mean numbers of lymph nodes removed were 25.0 ± 7.4 and 28.9 ± 8.2 in the robotic and co...
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Robotic Selective Neck Dissection using a gasless postauricular facelift approach for early head and Neck cancer: technical feasibility and safety.
Journal of laparoendoscopic & advanced surgical techniques. Part A, 2013Co-Authors: Kyung Tae, Chang Myeon Song, Hyun Jung Min, Kyung Rae Kim, Chul Won ParkAbstract:Abstract Background: Scarless and minimally invasive surgery is becoming popular in the head and Neck area. We have developed a new robotic Selective Neck Dissection procedure for head and Neck squamous cell carcinoma (HNSCC) to avoid a long visible lateral Neck scar. Here we report on the technical feasibility and safety of our procedure. Subjects and Methods: We prospectively analyzed 4 patients with early HNSCC who underwent transoral robotic surgery (TORS) and concomitant robotic Selective Neck Dissection via a gasless postauricular facelift approach using the da Vinci® Surgical System (Intuitive Surgical Inc., Sunnyvale, CA). Results: Of these patients, 3 were male, and 1 was female. The mean age was 59.0±8.8 years. All patients had tongue cancer, with a clinically negative Neck. Three patients were T1, and 1 patient was T2. All patients underwent partial glossectomy by TORS and elective robotic Selective Neck Dissection including levels I, II, and III. The robotic Selective Neck Dissection procedure...
Song Fan - One of the best experts on this subject based on the ideXlab platform.
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the latest advancements in Selective Neck Dissection for early stage oral squamous cell carcinoma
Current Treatment Options in Oncology, 2017Co-Authors: Zongshan Shen, Weiliang Chen, Song FanAbstract:The management of cervical lymph node metastasis remains a crucial component of the treatment of head and Neck cancers. However, the proper management of clinical N 0 cases with early-stage oral squamous cell carcinoma (OSCC) remains undefined. In the advent of minimally invasive techniques in the 1980s, these techniques have gained popularity among numerous surgeons in all fields of surgery. Although there are no randomized controlled trial data comparing the outcomes of minimally invasive techniques (endoscopically assisted Selective Neck Dissection (SND), robot-assisted SND) with conventional techniques, encouraging evidence from several studies suggests that both endoscopically assisted SND and robot-assisted SND are safe, minimally invasive techniques with achieved short-term oncologic outcomes and can reach a better cosmetic outcome than conventional SND. In this review, we also compare the indications, surgical approaches, and relative advantages and disadvantages of conventional SND, endoscopically assisted SND, and robot-assisted SND to provide surgeons with a means to better consider these techniques for the treatment of early-stage OSCC.
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endoscopic assisted Selective Neck Dissection via small lateral Neck incision for early stage t1 2n0m0 head and Neck squamous cell carcinoma 3 year follow up results
Surgical Endoscopy and Other Interventional Techniques, 2017Co-Authors: Faya Liang, Song Fan, Ping Han, Qian Cai, Peiliang Lin, Renhui Chen, Xiaoming HuangAbstract:Background Primary tumors of early-stage (T1-2N0M0) head and Neck squamous cell carcinoma (HNSCC) can be treated by transoral minimally invasive surgery, but the cervical lymph node lacks corresponding minimally invasive treatment. Therefore, our study was to evaluate the safety and effectiveness of endoscopic-assisted Selective Neck Dissection (EASND) via small lateral Neck incision in treatment of early-stage HNSCC.
Francisco Vieira - One of the best experts on this subject based on the ideXlab platform.
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Efficacy of super-Selective Neck Dissection following chemoradiation for advanced head and Neck cancer
Oral oncology, 2012Co-Authors: K. Thomas Robbins, Muthuswamy Dhiwakar, Krishna Rao, Francisco Vieira, James MaloneAbstract:Summary Background Hypothesizing that Neck-level specific locations of residual lymph node metastases following chemoradiation for head and Neck cancer are highly predictable, the efficacy of the more targeted lymphadenectomy procedure called super-Selective Neck Dissection (SSND) was evaluated. Methods A retrospective analysis of the databases from 2 institutions indicated that 35 SSND’s were performed on 30 patients following chemoradiation as either a planned or early salvage intervention. Results Over a median follow-up of 33 (range: 8–72) months, 8 patients developed recurrent disease (3 primary, 5 distant) but there were no isolated recurrences in the Neck. The projected 5 year disease specific survival rate for the group was 60%. Conclusions SSND is an effective intervention for patients with advanced head and Neck cancer treated with chemoradiation whose risk for residual nodal disease is confined to one level.
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Selective Neck Dissection as an early salvage intervention for clinically persistent nodal disease following chemoradiation
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2012Co-Authors: Muthuswamy Dhiwakar, Krishna Rao, Francisco Vieira, Thomas K Robbins, James MaloneAbstract:Background The aim of this study was to determine the efficacy of Selective Neck Dissection (SND) performed for persistent nodal disease after chemoradiation. Methods Patients treated with definitive chemoradiation for squamous cell carcinoma of the head and Neck who subsequently underwent SND for early salvage of clinically persistent nodal disease were evaluated. The primary outcome measure was regional disease control. Results A total of 62 patients underwent 69 SND procedures. The median time interval between completion of chemoradiation and Neck Dissection was 10 weeks. There was evidence of residual tumor in 32 Neck Dissection specimens (46%). Forty patients (65%) remained free of disease, whereas the remaining 22 patients (35%) developed a recurrence, among which 4 were regional. Of these, 3 occurred in the contralateral Neck and only 1 occurred in the targeted (ipsilateral) Neck. Conclusions SND is an effective early salvage intervention for persistent nodal disease in patients treated with chemoradiation. © 2011 Wiley Periodicals, Inc. Head Neck, 2012
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Efficacy of Selective Neck Dissection for nodal metastasis with involvement of nonlymphatic structures.
Head & neck, 2010Co-Authors: Muthuswamy Dhiwakar, K. Thomas Robbins, Krishna Rao, Francisco Vieira, James MaloneAbstract:Background. Our aim in carrying out this study was to determine the efficacy of Selective Neck Dissection (SND) for cervical metastases with clinical involvement of adjacent nonlymphatic structures. Methods. In all, 39 patients were retrospectively analyzed with respect to 43 extended Selective Neck Dissection (ESND) procedures. Results. Eighteen procedures were performed as part of the primary treatment and 25 for salvage following (chemo)radiation. Although most patients (84%) had nodal disease ≥N2, 91% had disease clinically confined to ≤2 Neck levels. SND (levels II–IV) was most commonly performed and the internal jugular vein was the nonlymphatic structure most often sacrificed. Recurrence rate in the ipsilateral targeted Neck was 0% and 13% in the primary surgery and postradiation groups, respectively. Conclusions. SND that is extended to include adjacent nonlymphatic structures appears to be effective for advanced nodal metastasis confined to ≤2 nodal levels. We support the use of the term “extended Selective Neck Dissection (ESND)” to describe this modification of Neck Dissection. © 2010 Wiley Periodicals, Inc. Head Neck, 2011
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Effectiveness of SuperSelective and Selective Neck Dissection for Advanced Nodal Metastases After Chemoradiation
Archives of otolaryngology--head & neck surgery, 2005Co-Authors: K. Thomas Robbins, Sandeep Samant, Ilana Doweck, Francisco VieiraAbstract:Objective: To determine the efficacy of Selective and superSelective Neck Dissection for patients with bulky or residual nodal metastasis treated with concomitant intra-arterial cisplatin and radiotherapy. Design: Prospective study. Setting: University of Tennessee, Memphis. Patients: A total of 240 patients with stage III or IV head and Neck squamous cell carcinoma. Interventions: Treatment with cisplatin, 150 mg/m 2 intra-arterially, and sodium thiosulfate, 9 g/m 2 intravenously, weekly for 4 weeks; and radiotherapy, 2 Gy per fraction per day, 5 times weekly, for a total of 68 to 74Gy over 6 to 7 weeks. Main Outcome Measures: Regional control, distant metastases, and overall survival for patients undergoing radical or modified radical Neck Dissection (n=12), Selective Neck Dissection (n=65), and superSelective Neck Dissection (levels II-III only) (n=7). Results: Among the total group of 240 patients, 106 Neck Dissections were performed on 84 patients who had bulky nodal disease. With a median follow-up of 58 months (range, 12-96 months), regional failure occurred in 11 (4.6%) of 240 patients: 2 (17%) of the 12 who had modified radical Neck Dissection, 3 (5%) of the 65 who had Selective Neck Dissection, none of the 7 patients who had superSelective Neck Dissection, and 6 (4%) of the 156 who had no Neck Dissection. The rates of overall survival and distant metastases were not significantly different among the 3 Neck Dissection subsets. Conclusion: Selective and superSelective Neck Dissection, which spare function and minimize morbidity, are viable therapeutic alternatives for patients with residual disease confined to 1 level after intra-arterial chemoradiation treatment, and possibly for other chemoradiation protocols.
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Efficacy of Targeted Chemoradiation and Planned Selective Neck Dissection to Control Bulky Nodal Disease in Advanced Head and Neck Cancer
Archives of otolaryngology--head & neck surgery, 1999Co-Authors: K. Thomas Robbins, Francisco Vieira, Frank S. H. Wong, Parvesh Kumar, William F. Hartsell, Brent Mullins, H. Barry NiellAbstract:Purpose To determine the efficacy of targeted chemoradiation with the radiation plus platinum (RADPLAT) protocol and planned Selective Neck Dissection in patients with N2 to N3 nodal disease associated with upper aerodigestive tract carcinoma. Methods Analysis of 52 patients with N2a, N2b, or N3 disease involving 60 hemiNecks treated with intra-arterial cisplatin, 150 mg/m2, and intravenous sodium thiosulfate, 9 g/m2, on days 1, 8, 15, and 22; radiation therapy, 180 to 200 cGy per fraction for 35 fractions (total dose, 68-74 Gy); and planned Neck Dissection (33 of 35 procedures were Selective). Results Of the 56 evaluable hemiNecks, a clinical complete response was achieved in 33 (59%). Within this group, 16 Neck Dissections were performed, none of which yielded disease on pathological examination. A clinical partial response was obtained in 21 hemiNecks, of which 18 subsequently had a Neck Dissection, yielding disease on pathological examination in 14. In all cases, it was possible to completely excise all adenopathy with clear margins on pathological examination. The rate of regional disease control among the 56 evaluable hemiNecks was 91% (51/56) (median follow-up, 36 months). Four failures were associated with uncontrolled disease at other sites, and 1 was an isolated Neck recurrence. Conclusion Selective Neck Dissection appears to be an effective adjunct to targeted chemoradiation in controlling N2 to N3 Neck disease.
