Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-23T03:54:49.207Z Has data issue: false hasContentIssue false
  • English
  • Français

Neck dissection: cause and effect

Published online by Cambridge University Press:  03 March 2015

N Hirshoren ,
F Ashqar ,
J M Weinberger  and
R Eliashar
N Hirshoren*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Hadassah Medical Centre, Hebrew University of Jerusalem, Israel
F Ashqar
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Hadassah Medical Centre, Hebrew University of Jerusalem, Israel
J M Weinberger
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Hadassah Medical Centre, Hebrew University of Jerusalem, Israel
R Eliashar
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Hadassah Medical Centre, Hebrew University of Jerusalem, Israel
*
Address for correspondence: Dr N Hirshoren, Department of Otolaryngology – Head and Neck Surgery, Hadassah Ein-Kerem, Jerusalem 91120, Israel Fax: 972-2-6435090 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This study aimed to evaluate changes in neck dissection procedures over time in a tertiary university hospital to determine their influence on residency training.

Methods:

Neck dissections performed in a recent decade (2003–2012) were retrospectively analysed and compared with those of an earlier decade (1981–1990).

Results:

Nowadays, neck dissections are most frequently performed for thyroid (2003–2012 vs 1981–1990: 60.7 per cent vs 25 per cent, p = 0.002) and less often for epithelial malignancies (23.2 per cent vs 53.5 per cent, p = 0.002). Compared with dissections for thyroid spread, more dissections for epithelial malignancies are extensive (epithelial vs thyroid malignancies, 66 per cent vs 4.9 per cent) and more are performed after chemoradiation failures (25.6 per cent vs 0 per cent).

Conclusion:

This study demonstrates changes in neck dissection procedures over time. There is an increasing preference for conservative treatment for epithelial cancers. In addition, there is a large increase in both the diagnosis and surgical treatment of thyroid cancer. This shift may have a great effect on residents’ learning curves and on their ability to achieve competency in performing neck dissections.

Keywords

Neck DissectionSquamous Cell CarcinomaThyroid CancerOrgan Preservation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 4 , April 2015 , pp. 369 - 371
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Rinaldo, A, Ferlito, A, Silver, CE. Early history of neck dissection. Eur Arch Otorhinolaryngol 2008;265:1535–8Google Scholar
2Crile, G. Excision of cancer of the head and neck, with special reference to the plan of dissection based on 132 patients. JAMA 1906;47:1780–8Google Scholar
3The Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991;13;324:1685–90Google Scholar
4Fountzilas, G, Daniilidis, J, Kosmidis, P, Sridhar, KS, Kalogera-Fountzila, A, Banis, K et al. Platinum-based induction chemotherapy followed by radiation as definitive treatment for patients with locally advanced cancer of the oral cavity, oropharynx and hypopharynx. A retrospective analysis of 32 cases. J Chemother 1991;3:183–8Google Scholar
5Pfister, DG, Harrison, LB, Strong, EW, Shah, JP, Spiro, RW, Kraus, DH et al. Organ-function preservation in advanced oropharynx cancer: results with induction chemotherapy and radiation. J Clin Oncol 1995;13:671–80CrossRefGoogle ScholarPubMed
6Kraus, DH, Pfister, DG, Harrison, LB, Shah, JP, Spiro, RH, Armstrong, JG et al. Larynx preservation with combined chemotherapy and radiation therapy in advanced hypopharynx cancer. Otolaryngol Head Neck Surg 1994;111:31–7Google Scholar
7Sosa, JA, Hanna, JW, Robinson, KA, Lanman, RB. Increases in thyroid nodule fine-needle aspirations, operations, and diagnoses of thyroid cancer in the United States. Surgery 2013;154:1420–7Google Scholar