What are the United Kingdom (UK) National Multidisciplinary Guidelines for use of selective neck dissection in the management of neck metastases?

Answer

United Kingdom (UK) National Multidisciplinary Guidelines from 2016 on the management of neck metastases in head and neck cancer included the following recommendations with regard to selective neck dissection^[18]:

Selective neck dissection is as effective as modified radical neck dissection for controlling regional disease in N0 necks for all primary sites
Selective neck dissection alone is adequate treatment for pN1 neck disease without adverse histologic features

UK National Multidisciplinary Guidelines from 2016 regarding recurrent head and neck cancer included the following recommendations^[19]:

Consider elective selective neck dissections in patients with recurrent primaries with N0 necks, especially in advanced cases
Selective neck dissection (with preservation of nodal levels, especially level V, that are not involved by disease) in patients with nodal (N+) recurrence appears to be as effective as modified or radical neck dissections

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Media Gallery

Selective neck dissection levels I-III.
Selective neck dissection levels II-IV.
Selective neck dissection for thyroid cancer: selective neck dissection VI, or anterior neck dissection.
Selective neck dissection for posterior scalp and upper posterolateral neck cutaneous malignancies: selective neck dissection II-V, postauricular, suboccipital, or posterolateral neck dissection.
The 6 levels of the neck with sublevels.

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Author

Ron Mitzner, MD Resident Physician, Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, Penn State University College of Medicine, Milton S Hershey Medical Center

Ron Mitzner, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Karen H Calhoun, MD, FACS, FAAOA Professor, Department of Otolaryngology-Head and Neck Surgery, Ohio State University College of Medicine

Karen H Calhoun, MD, FACS, FAAOA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Head and Neck Society, Association for Research in Otolaryngology, Southern Medical Association, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Rhinologic Society, Society of University Otolaryngologists-Head and Neck Surgeons, Texas Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;Cliexa;The Physicians Edge;Sync-n-Scale;mCharts<br/>Received income in an amount equal to or greater than $250 from: The Physicians Edge, Cliexa;Proforma;Neosoma<br/> Received stock from RxRevu; Received ownership interest from Cerescan for consulting; .

Additional Contributors

Benoit J Gosselin, MD, FRCSC Associate Professor of Surgery, Dartmouth Medical School; Director, Comprehensive Head and Neck Oncology Program, Norris Cotton Cancer Center; Staff Otolaryngologist, Division of Otolaryngology-Head and Neck Surgery, Dartmouth-Hitchcock Medical Center

Benoit J Gosselin, MD, FRCSC is a member of the following medical societies: American Head and Neck Society, American Academy of Facial Plastic and Reconstructive Surgery, North American Skull Base Society, American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Rhinologic Society, Canadian Medical Association, Canadian Society of Otolaryngology-Head & Neck Surgery, College of Physicians and Surgeons of Ontario, New Hampshire Medical Society, Ontario Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Francis P Ruggiero, MD Assistant Professor, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Penn State University, Milton S Hershey Medical Center

Francis P Ruggiero, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery and American Medical Association

Disclosure: Nothing to disclose.

Sandeep Samant, MBBS MS, FRCS, Chief, Division of Head and Neck and Skull Base Surgery, Associate Professor, Department of Otolaryngology-Head and Surgery, University of Tennessee Health Sciences Center

Sandeep Samant, MBBS is a member of the following medical societies: Royal College of Surgeons of England

Disclosure: Nothing to disclose.

What are the United Kingdom (UK) National Multidisciplinary Guidelines for use of selective neck dissection in the management of neck metastases?

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