How is extended neck dissection defined, and what are prognostic factors in extended neck dissection for HPV-related oropharyngeal SCC?

Updated: Aug 19, 2020
  • Author: Ron Mitzner, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

In cases of advanced neck disease, certain lymphatic or nonlymphatic structures not routinely included in the aforementioned neck dissections may have to be removed. Extended neck dissection is the term used to describe these procedures. Retropharyngeal lymph nodes, the hypoglossal nerve, portions of the prevertebral musculature, or the carotid artery are some of the structures that may occasionally have to be excised to obtain negative margins. All additional lymphatic and nonlymphatic structures removed should be identified in parentheses.

In a study of extended neck dissection in 72 patients with human papillomavirus (HPV)–related oropharyngeal squamous cell carcinoma (SCC), Zenga et al reported that advanced T classification, a pathologic node number of five or more, and no employment of adjuvant radiotherapy were associated with a reduced disease-free survival rate. [25]


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