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Current Treatment Options in Oncology

, Volume 15, Issue 4, pp 611–624 | Cite as

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

  • Marc Hamoir
  • Sandra Schmitz
  • Vincent Gregoire
Head and Neck Cancer (J-P Machiels, Section Editor)

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.

Keywords

Head and neck cancer Neck dissection Chemoradiotherapy Squamous cell carcinoma Neck metastases 

Notes

Compliance with Ethics Guidelines

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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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Marc Hamoir
    • 1
    • 2
  • Sandra Schmitz
    • 1
    • 2
  • Vincent Gregoire
    • 2
    • 3
  1. 1.Department of Head and Neck Surgery, Head and Neck Oncology ProgramSt Luc University HospitalBrusselsBelgium
  2. 2.King Albert II Cancer Institute, Institut de Recherche Expérimentale et Clinique (IREC)Université Catholique de LouvainBrusselsBelgium
  3. 3.Department of Radiation Oncology, Head and Neck Oncology ProgramSt Luc University Hospital1200 BrusselsBelgium

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