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 radiotherapy 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.