Advantages of Selective Neck Dissection, A 3-Year Follow-up Study

Year 2015, Volume: 4 Issue: 2, 141 - 145, 01.05.2015

Şahin Ulu Ela Cömert Necmi Arslan Engin Dursun

https://doi.org/10.5505/abantmedj.2015.87609

Abstract

OBJECTIVE: The main spread of head and neck cancers is through lymphatic system. A physician who will treat this region tumors should keep in mind lymphatic spread.Although there is a consensus for treatment of patients who have palpable lymphadenopathy at neck, the discussion is still ongoing for the treatment of N0 necks. Selective neck dissection is usually performed according to the localization of the primary tumor. It can be performed to both N0 and N + patients. METHODS: In our study, patients who had selective neck dissection due to head and neck malignant tumor and their Lymph node spreads were evaluated along with preoperative -postoperative imaging methods and pathology reports. 3-year follow-up results were analyzed.RESULTS: 3-year survival rate of 45 patients who had selective neck dissection and included in the study was found to be 92%. During 3-year follow-up period, neck recurrence was observed in 4 patients 8.8% . Of these 4 patients, 2 patients were followed up for larynx carcinoma and other 2 patients were followed up for lower lip carcinomas. CONCLUSION: In conclusion, due to the advantages of time and complications the reliability of selective neck dissection increases year after year. We believe that, with larger series of head and neck cancer, super-selective neck dissection will become more widely in the future.

Keywords

Lip tumors, laryngeal tumors, neck dissection

Selektif Boyun Diseksiyonunun Avantajları ve 3 Yıllık Takip Çalışması

Abstract

AMAÇ: Baş- boyun bölgesi kanserlerinin temel yayılımı lenfatik sistem yolu ile olur. Bu bölge tümörlerinin tedavisini yapacak olan bir hekimin lenfatik yayılımı mutlaka göz önünde bulundurması gerekir. Boyunda klinik olarak palpe edilebilen, metastatik lenfadenopatisi olan hastalarda tedavi için fikir birliği sağlanmış olmasına rağmen, N0 boyunlarda tedavi yöntemi hakkında net bir görüş yoktur. Selektif boyun diseksiyonu SBD genellikle primer tümörün lokalizasyonuna göre yapılmaktadır. Hem N0 hem de N+ hastalarda yapılabilmektedir.YÖNTEMLER: Çalışmamızda baş boyun malign tümörü nedeniyle opere edilen 45 hasta ve bu hastalara yapılan 79 selektif boyun diseksiyonu değerlendirildi. SBD yapılan hastaların 3 yıllık takip sonuçları incelendi.BULGULAR: Çalışmaya katılan hastaların 3 yıllık sağkalım oranı %92 olarak bulundu. Ortalama 3 yıllık takiplerde 4 hastada %8,8 boyunda rekürrens görüldü. Hiç bir hastamızda IIb bölgesine metastaz tespit edilmedi. SBD yapılan hastalarımızda daha az komplikasyon gözlendi ve diğer boyun diseksiyonlarına göre daha kısa bir sürede yapıldı. SONUÇ: Sonuç olarak SBD’nun süre ve komplikasyon avantajları nedeniyle her geçen gün daha çok tercih edilen bir yöntem olmaktadır. İleride, baş boyun kanserlerinde geniş serilerle yapılacak çalışmalarla süper SBD’nun daha yaygın hale geleceğine inanmaktayız.

Keywords

Boyun diseksiyonu, selektif boyun diseksiyonu, metastaz

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