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The Role of Neck Dissection in Squamous Cell Carcinoma of the Head and Neck

  • Head and Neck Cancer (J-P Machiels, Section Editor)
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Original statement

Lymph node metastases in the neck are a major prognostic factor in patients with head and neck squamous cell carcinoma (HNSCC). Assessment and treatment of lymph nodes in the neck are of utmost importance. Inappropriate management of lymph node metastases can result in regional failure. Radical neck dissection has been and is still considered the “gold standard” for the surgical management of lymph node metastases of HNSCC. However, the philosophy of treatment of the neck has evolved during the last decades. Surgeons progressively realized that extensive neck dissections were associated with a higher morbidity but not always with a better oncologic outcome than more limited procedures. Today, a comprehensive therapeutic approach of the neck is multidisciplinary, taking into account the patient’s quality of life without jeopardizing cure and survival. A better understanding of the patterns of lymph node metastasis promoted the use of selective neck dissection in selected patients. Sentinel lymph node biopsy is a reliable diagnostic procedure for staging the neck in node-negative early oral cavity squamous cell carcinoma. With increasing use of chemoradiation in locally advanced HNSCC, paradigms are evolving. Currently, there are strong arguments supporting the position that neck dissection is no longer justified in patients without clinically residual disease in the neck.

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Conflict of InterestMarc Hamoir, Sandra Schmitz, and Vincent Grégoire declare that they have no conflict of interest.

Human and Animal Rights and Informed ConsentThis article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital, Hippocrate Avenue, 10, 1200, Brussels, Belgium

    Marc Hamoir MD & Sandra Schmitz MD, PhD

  2. King Albert II Cancer Institute, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Hippocrate Avenue, 10, 1200, Brussels, Belgium

    Marc Hamoir MD, Sandra Schmitz MD, PhD & Vincent Gregoire MD, PhD

  3. Department of Radiation Oncology, Head and Neck Oncology Program, St Luc University Hospital, Hippocrate Avenue, 10, 1200 Brussels, Belgium

    Vincent Gregoire MD, PhD

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Correspondence to Marc Hamoir MD.

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Hamoir, M., Schmitz, S. & Gregoire, V. The Role of Neck Dissection in Squamous Cell Carcinoma of the Head and Neck. Curr. Treat. Options in Oncol. 15, 611–624 (2014). https://doi.org/10.1007/s11864-014-0311-7

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