Oral Oncology
Volume 39, Issue 5 , Pages 429-435 , July 2003

Changing concepts in the surgical management of the cervical node metastasis

  • Alfio Ferlito

      Affiliations

    • Department of Otolaryngology—Head and Neck Surgery, University of Udine, Policlinico Universitario, Piazzale S. Maria della Misericordia, I-33100, Udine, Italy
    • Corresponding Author InformationCorresponding author. Tel.: +39-0432-559302; fax: +39-0432-559339
    • ,
  • Alessandra Rinaldo

      Affiliations

    • Department of Otolaryngology—Head and Neck Surgery, University of Udine, Policlinico Universitario, Piazzale S. Maria della Misericordia, I-33100, Udine, Italy
    • ,
  • K. Thomas Robbins

      Affiliations

    • Gainesville, FL, USA
    • ,
  • C. René Leemans

      Affiliations

    • Department of Otolaryngology—Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
    • ,
  • Jatin P. Shah

      Affiliations

    • Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
    • ,
  • Ashok R. Shaha

      Affiliations

    • Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
    • ,
  • Peter E. Andersen

      Affiliations

    • Department of Otolaryngology, Oregon Health and Science University, Portland, OR, USA
    • ,
  • Luiz P. Kowalski

      Affiliations

    • Head and Neck Surgery and Otorhinolaryngology Department, Centro de Tratamento e Pesquisa Hospital do Cancer A. C. Camargo, São Paulo, Brazil
    • ,
  • Phillip K. Pellitteri

      Affiliations

    • Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
    • ,
  • Gary L. Clayman

      Affiliations

    • Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
    • ,
  • Simon N. Rogers

      Affiliations

    • Department of Oral and Maxillofacial Surgery, University Hospital Aintree and Liverpool University Dental Hospital, Liverpool, UK
    • ,
  • Jesus E. Medina

      Affiliations

    • Department of Otolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
    • ,
  • Robert M. Byers

      Affiliations

    • Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

Received 13 January 2003 ,Accepted 13 January 2003.

References 

  1. Andersen PE, Shah JP, Cambronero E, Spiro RH. The role of comprehensive neck dissection with preservation of the spinal accessory nerve in the clinically positive neck. Am J Surg. 1994;168:499–502
  2. Moe K, Wolf GT, Fisher SG, Hong WK. Regional metastases in patients with advanced laryngeal cancer. Department of Veterans Affairs Laryngeal Cancer Study Group. Arch Otolaryngol Head Neck Surg. 1996;122:644–648
  3. Hahn SS, Spaulding CA, Kim JA, Constable WC. The prognostic significance of lymph node involvement in pyriform sinus and supraglottic cancers. Int J Radiat Oncol Biol Phys. 1987;13:1143–1147
  4. Johnson JT, Barnes EL, Myers EN, Schramm VL, Borochovitz D, Sigler BA. The extracapsular spread of tumors in cervical node metastasis. Arch Otolaryngol. 1981;107:725–729
  5. Shah JP. Head and neck surgery. 2nd edn.. New York: Mosby-Wolfe; 1996;
  6. Ferlito A, Shaha AR, Rinaldo A. The incidence of lymph node micrometastases in patients pathologically staged N0 in cancer of oral cavity and oropharynx. Oral Oncol. 2002;38:3–5
  7. Ferlito A, Partridge M, Brennan JA, Hamakawa H. Lymph node micrometastases in head and neck cancer (a review). Acta Otolaryngol. 2001;121:660–665
  8. Ferlito A, Devaney KO, Rinaldo A, Devaney SL, Carbone A. Micrometastases (have they an impact on prognosis?). Ann Otol Rhinol Laryngol. 1999;108:1185–1189
  9. Ferlito A, Rinaldo A. False negative conventional histology of lymph nodes in patients with head and neck cancer. ORL J Otorhinolaryngol Relat Spec. 2000;62:112–114
  10. Spiro RH, Huvos AG, Wong GY, Spiro JD, Gnecco CA, Strong EW. Predictive value of tumor thickness in squamous carcinoma confined to the tongue and floor of the mouth. Am J Surg. 1986;152:345–350
  11. Devaney SL, Ferlito A, Rinaldo A, Devaney KO. Pathologic detection of occult metastases in regional lymph nodes in patients with head and neck cancer. Acta Otolaryngol. 2000;120:344–349
  12. Devaney SL, Ferlito A, Rinaldo A, Devaney KO. The pathology of neck dissection in cancer of the larynx. ORL J Otorhinolaryngol Relat Spec. 2000;62:204–211
  13. Ferlito A, Rinaldo A. Controversies in the treatment for No neck in laryngeal cancer (neck dissection, no surgery or sentinel lymph node biopsy?). ORL J Otorhinolaryngol Relat Spec. 2000;62:287–289 (Editorial)
  14. Ferlito A, Devaney KO, Devaney SL, Rinaldo A. What is the incidence of occult metastasis in patients with stage No cancers of the head and neck?. ORL J Otorhinolaryngol Relat Spec. 2001;63:1–5 (Editorial)
  15. Ferlito A, Devaney KO, Rinaldo A. Is it time to develop an “ultrastaging system” for use in patients with head and neck malignancies?. Laryngoscope. 2001;111:185–186(Commentary)
  16. Ferlito A, Boccato P, Shaha AR, Carbone A, Noyek AM, Doglioni C, et al. The art of diagnosis in head and neck tumors. Acta Otolaryngol. 2001;121:324–328
  17. Crile G. Excision of cancer of the head and neck. With special reference to the plan of dissection based on 132 patients. JAMA. 1906;47:1780–1786
  18. Martin HE, Del Valle B, Ehrlich H, Cahan WG. Neck dissection. Cancer. 1951;4:441–499
  19. Nahum AM, Mullally W, Marmor L. A syndrome resulting from radical neck dissection. Arch Otolaryngol. 1961;74:82–86
  20. Ward GE, Robben JO. A composite operation for radical neck dissection and removal of cancer of the mouth. Cancer. 1951;4:98–109
  21. Saunders JR, Hirata RM, Jaques DA. Considering the spinal accessory nerve in head and neck surgery. Am J Surg. 1985;150:491–494
  22. Magrin J, Kowalski LP. Bilateral radical neck dissection (results in 193 cases). J Surg Oncol. 2000;75:232–240
  23. Hosal AS. Is radical neck dissection the only surgical option for the N+ neck?. Proc 5th Int Conf Head Neck Cancer, San Francisco. 2000;457–462
  24. Suárez O. El problema de las metastasis linfáticas y alejadas del cáncer de laringe e hipofaringe. Rev Otorrinolaringol. 1963;23:83–99
  25. Ferlito A, Gavilán J, Buckley JG, Shaha AR, Miodonski AJ, Rinaldo A. Functional neck dissection (fact and fiction). Head Neck. 2001;23:804–808
  26. Leemans CR, Tiwari RM, van der Waal I, Karim ABMF, Nauta JJP, Snow GB. The efficacy of comprehensive neck dissection with or without postoperative radiotherapy in nodal metastases of squamous cell carcinoma of the upper respiratory and digestive tracts. Laryngoscope. 1990;100:1194–1198
  27. Ballantyne AJ. Classical and functional neck dissection. In:  Ariyan S editors. Cancer of the head and neck. St Louis: C.V. Mosby Company; 1987;
  28. Robbins KT, Clayman G, Levine PA, Medina J, Sessions R, Shaha A, et al. American Academy of Otolaryngology-Head and Neck Surgery. Neck dissection classification update. Revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology—Head and Neck Surgery. Arch Otolaryngol Head Neck Surg. 2002;128:751–758
  29. Ferlito A. Classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg. 2002;128:747–748 (Commentary)
  30. Kuntz AL, Weymuller EA. Impact of neck dissection on quality of life. Laryngoscope. 1999;109:1334–1338
  31. Fisch UP, Sigel ME. Cervical lymphatic system as visualized by lymphography. Ann Otol. 1964;73:869–882
  32. Lindberg R. Distribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer. 1972;29:1446–1449
  33. Skolnik EM, Yee KF, Friedman M, Golden TA. The posterior triangle in radical neck surgery. Arch Otolaryngol. 1976;102:1–4
  34. Byers RM, Wolf PF, Ballantyne AJ. Rationale for elective modified neck dissection. Head Neck Surg. 1988;10:160–167
  35. Shah JP. Patterns of cervical lymph node metastasis from squamous carcinoma of the upper aerodigestive tract. Am J Surg. 1990;160:405–409
  36. Candela FC, Kothari K, Shah JP. Patterns of cervical node metastases from squamous cell carcinoma of the oropharynx and hypopharynx. Head Neck. 1990;12:197–203
  37. Shah JP, Candela FC, Poddar AK. The patterns of cervical lymph node metastases from squamous cell carcinoma of the oral cavity. Cancer. 1990;66:109–113
  38. Candela FC, Shah J, Jaques DP, Shah JP. Patterns of cervical node metastases from squamous cell carcinoma of the larynx. Arch Otolaryngol Head Neck Surg. 1990;116:432–435
  39. Mukherji SK, Armao D, Joshi VM. Cervical nodal metastases in squamous cell carcinoma of the head and neck (what to expect). Head Neck. 2001;23:995–1005
  40. Wong RJ, Rinaldo A, Ferlito A, Shah JP. Occult cervical metastasis in head and neck cancer and its impact on therapy. Acta Otolaryngol. 2002;122:107–114
  41. Kowalski LP, Carvalho AL. Feasibility of supraomohyoid neck dissection in N1 and N2a oral cancer patients. Head Neck. 2002;24:921–924
  42. Brazilian Head and Neck Cancer Study Group. End results of a prospective trial on elective lateral neck dissection vs type III modified radical neck dissection in the management of supraglottic and transglottic carcinomas. Head Neck. 1999;21:694–702
  43. Buckley JG, MacLennan K. Cervical node metastases in laryngeal and hypopharyngeal cancer (a prospective analysis of prevalence and distribution). Head Neck. 2000;22:380–385
  44. Andersen PE, Warren F, Spiro J, Burningham A, Wong R, Wax MK, et al. Results of selective neck dissection in management of the node-positive neck. Arch Otolaryngol Head Neck Surg. 2002;128:1180–1184
  45. Traynor SJ, Cohen JI, Gray J, Andersen PE, Everts EC. Selective neck dissection and the management of the node-positive neck. Am J Surg. 1996;172:654–657
  46. Davidson BJ, Kulkarny V, Delacure MD, Shah JP. Posterior triangle metastases of squamous cell carcinoma of the upper aerodigestive tract. Am J Surg. 1993;166:395–398
  47. León X, Quer M, Orús C, Sancho FJ, Bagué S, Burgués J. Selective dissection of levels II-III with intraoperative control of the upper and middle jugular nodes (a therapeutic option for the N0 neck). Head Neck. 2001;23:441–446
  48. Pitman KT, Johnson JT, Myers EN. Effectiveness of selective neck dissection for management of the clinically negative neck. Arch Otolaryngol Head Neck Surg. 1997;123:917–922
  49. Spiro RH, Gallo O, Shah JP. Selective jugular node dissection in patients with squamous carcinoma of the larynx or pharynx. Am J Surg. 1993;166:399–402
  50. Ambrosch P, Freudenberg L, Kron M, Steiner W. Selective neck dissection in the management of squamous cell carcinoma of the upper digestive tract. Eur Arch Otorhinolaryngol. 1996;253:329–335
  51. Byers RM, Clayman GL, McGill D, Andrews T, Kare RP, Roberts DB, et al. Selective neck dissections for squamous carcinoma of the upper aerodigestive tract (patterns of regional failure). Head Neck. 1999;21:499–505
  52. Myers EN, Fagan JJ. Management of the neck in cancer of the larynx. Ann Otol Rhinol Laryngol. 1999;108:828–832
  53. Davidson J, Khan Y, Gilbert R, Birt BD, Balogh J, MacKenzie R. Is selective neck dissection sufficient treatment for the N0/Np+ neck?. J Otolaryngol. 1997;26:229–231
  54. Clayman GL, Frank DK. Selective neck dissection of anatomically appropriate levels is as efficacious as modified radical neck dissection for elective treatment of the clinically negative neck in patients with squamous cell carcinoma of the upper respiratory and digestive tracts. Arch Otolaryngol Head Neck Surg. 1998;124:348–352
  55. Houck JR, Medina JE. Management of cervical lymph nodes in squamous carcinomas of the head and neck. Semin Surg Oncol. 1995;11:228–239
  56. Pellitteri PK, Robbins KT, Neuman T. Expanded application of selective neck dissection with regard to nodal status. Head Neck. 1997;19:260–265
  57. Ferlito A, Buckley JG, Shaha AR, Rinaldo A. Rationale for selective neck dissection in tumors of the upper aerodigestive tract. Acta Otolaryngol. 2001;121:548–555 (Editorial)
  58. Ferlito A, Rinaldo A, Devaney KO, MacLennan K, Myers JN, Petruzzelli GJ, et al. Prognostic significance of microscopic and macroscopic extracapsular spread from metastatic tumor in the cervical lymph nodes. Oral Oncol. 2002;38:747–751
  59. Woolgar JA, Rogers SN, Lowe D, Brown JS, Vaughan ED. Cervical lymph node metastasis in oral cancer (the importance of even microscopic extracapsular spread). Oral Oncol. 2003;39:130–137
  60. Buckley JG, Feber T. Surgical treatment of cervical node metastases from squamous carcinoma of the upper aerodigestive tract (evaluation of the evidence for modifications of neck dissection). Head Neck. 2001;23:907–915
  61. Lingeman RE, Helmus C, Stephens R, Ulm J. Neck dissection (radical or conservative). Ann Otol. 1977;86:737–744
  62. Molinari R, Cantù G, Chiesa F, Grandi C. Retrospective comparison of conservative and radical neck dissection in laryngeal cancer. Ann Otol. 1980;89:578–581
  63. Brandenburg JH, Lee CYS. The eleventh nerve in radical neck surgery. Laryngoscope. 1981;91:1851–1859
  64. Deutsch EC, Skolnik EM, Friedman M, Hill JH, Sharer K. The conservation neck dissection. Laryngoscope. 1985;95:561–565
  65. Mann W, Wolfensberger M, Füller U, Beck C. [Radical versus modified neck dissection. Cancer-related and functional viewpoints]. Laryngorhinootologie. 1991;70:32–35
  66. Jesse RH, Ballantyne AJ, Larson D. Radical or modified neck dissection (a therapeutic dilemma). Am J Surg. 1978;136:516–519
  67. Ambrosch P, Kron M, Pradier O, Steiner W. Efficacy of selective neck dissection (a review of 503 cases of elective and therapeutic treatment of the neck in squamous cell carcinoma of the upper aerodigestive tract). Otolaryngol Head Neck Surg. 2001;124:180–187
  68. Chepeha DB, Hoff PT, Taylor RJ, Bradford CR, Teknos TN, Esclamado RM. Selective neck dissection for the treatment of neck metastasis from squamous cell carcinoma of the head and neck. Laryngoscope. 2002;112:434–438
  69. Ferlito A, Shaha AR, Rinaldo A. Surgical management of head and neck cancer (the next decade). Acta Otolaryngol. 2001;121:772–776 (Editorial)
  70. Konsulov SS, Yovchev IP, Doikov IY, Pazardjikliev DD. Selective neck dissection in treatment of node-positive neck cases. Folia Med (Plovdiv). 2001;43:27–29
  71. Doweck I, Robbins KT, Mendenhall WM, Hinerman RW, Amdur R. Neck level-specific nodal metastases in oropharyngeal cancer: is there a role for selective neck dissection following definitive radiation therapy? Head Neck (in press).
  72. Hehr T, Classen J, Schreck U, Glocker S, Koitschev A, Bamberg M, et al. Selective lymph node dissection following hyperfractionated accelerated radio-(chemo-)therapy for advanced head and neck cancer. Strahlenther Onkol. 2002;178:363–368
  73. Nigauri T, Kamata S, Kawabata K, Hoki K, Mitani H, Yoshimoto S, et al. [Treatment strategy for cervical node metastasis from squamous cell carcinoma of the oropharynx]. Nippon Jibiinkoka Gakkai Kaiho. 2000;103:803–811
  74. Boyd TS, Harari PM, Tannehill SP, Voytovich MC, Hartig GK, Ford CN, et al. Planned postradiotherapy neck dissection in patients with advanced head and neck cancer. Head Neck. 1998;20:132–137
  75. Robbins KT, Wong FS, Kumar P, Hartsell WF, Vieira F, Mullins B, et al. Efficacy of targeted chemoradiation and planned selective neck dissection to control bulky nodal disease in advanced head and neck cancer. Arch Otolaryngol Head Neck Surg. 1999;125:670–675
  76. Clayman GL, Johnson CJ, Morrison W, Ginsberg L, Lippman SM. The role of neck dissection after chemoradiotherapy for oropharyngeal cancer with advanced nodal disease. Arch Otolaryngol Head and Neck Surg. 2001;127:135–139
  77. Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, et al. Technical details of the intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992;127:392–399
  78. Pan D, Narayan D, Ariyan S. Merkel cell carcinoma (five case reports using sentinel lymph node biopsy and a review of 110 new cases). Plast Reconstr Surg. 2002;110:1259–1265
  79. Pitman KT, Johnson JT, Brown ML, Myers EN. Sentinel lymph node biopsy in head and neck squamous cell carcinoma. Laryngoscope. 2002;112:2101–2113
  80. Pitman KT, Ferlito A, Devaney KO, Shaha AR, Rinaldo A. Sentinel lymph node biopsy in head and neck cancer. Oral Oncol (in press).
  81. Ferlito A, Shaha AR, Rinaldo A. Evolution in the philosophy of neck dissection. Acta Otolaryngol. 2001;121:963–966
  82. Ferlito A, Robbins KT, Shaha AR, Pellitteri PK, Kowalski LP, Gavilán J, et al. Current considerations in neck dissection. Acta Otolaryngol. 2002;122:323–329
  83. Ferlito A, Pellitteri PK, Robbins KT, Shaha AR, Kowalski LP, Silver CE, et al. Management of the neck in cancer of the major salivary glands, thyroid and parathyroid glands. Acta Otolaryngol. 2002;122:673–678
  84. Ferlito A, Kowalski LP, Byers RM, Pellitteri PK, Bradley PJ, Rinaldo A, et al. Is the standard radical neck dissection no longer standard?. Acta Otolaryngol. 2002;122:792–795
  85. Myers EN, Gastman BR. Neck dissection: an operation in evolution. Arch Otolaryngol Head Surg. 2003;129:14–25
  86. Robbins KT, Atkinson JLD, Byers RM, Cohen JI, Lavertu P, Pellitteri P. The use and misuse of neck dissection for head and neck cancer. J Am Coll Surg. 2001;193:91–102
  87. Rogers SN, Gwanne S, Lowe D, Humphris G, Yueh B, Weymuller EA. The addition of mood and anxiety domains to the University of Washington Quality of Life Scale. Head Neck. 2002;24:521–529
  88. Sharp HM, List M, MacCracken E, Stenson K, Stocking C, Siegler M. Patients’ priorities among treatment effects in head and neck cancer (evaluation of a new assessment tool). Head Neck. 1999;21:538–546
  89. List MA, Stracks J, Colangelo L, Butler P, Ganzenko N, Lundy D, et al. How do head and neck cancer patients prioritize treatment outcomes before initiating treatment?. J Clin Oncol. 2000;18:877–884
  90. Allison PJ, Locker D, Feine JS. Quality of life (a dynamic construct). Soc Sci Med. 1997;45:221–230
  91. Ferlito A, Rogers SN, Shaha AR, Bradley PJ, Rinaldo A. Quality of life in head and neck cancer. Acta Otolaryngol. 2003;123:5–7 (Editorial)
  92. Nieuwenhuis EJC, Castelijns JA, Pijpers R, van den Brekel MWM, Brakenhoff RH, van der Waal I, et al. Wait-and-see policy for the N0 neck in early stage oral and oropharyngeal SCC using ultrasonography-guided cytology (is there a role for identification of the sentinel node?). Head Neck. 2002;24:282–289
  93. Ferlito A, Silver CE, Shaha AR, Rinaldo A. Management of N3 neck. Acta Otolaryngol. 2002;122:230–233

PII: S1368-8375(03)00010-1

doi: 10.1016/S1368-8375(03)00010-1

Oral Oncology
Volume 39, Issue 5 , Pages 429-435 , July 2003

Article Tools