When salvage laryngectomy is required in the setting of recurrent cancer after primary irradiation or chemoradiation therapy, is elective neck dissection always indicated?
Background: No prospective, randomized studies have been performed on this topic. Other authors report mixed findings. It is generally conceded that a risk of occult metastatic disease in excess of 20% justifies the use of elective neck dissection. In the setting of radio-resistant tumor at the primary site, concern exists that occult disease in the nodes may have been similarly resistant. Additionally, the risk to patients who had been initially node positive may be different from those who were clinically negative at the time of primary irradiation.
Explore this issue:January 2014
Study design: A retrospective study was based on the clinical records of patients who required salvage laryngectomy. All patients were node negative at the time of salvage surgery.
Setting: The study was performed between 1991 and 2011 at two academic medical centers.