الفهرس 
Aim of workOnly 14 pages are availabe for public view
 |  | from | 123 |  |  |
| | | from | 123 | | |
Abstract
Cancer of the head and neck includes all cancers arising from the upper aerodigestive tract, and typically refers to squamous cell carcinomas of the head and neck, which are the predominant group. Head and neck squamous cell carcinoma has shown a gradual increase in incidence over the last years.
The status of the regional cervical lymphatics is one of the most significant prognostic indicators. Head and neck cancers without lymph node metastasis usually have excellent cure rates with either surgery or radiotherapy, while those with the presence of regional metastases on presentation have significantly worse survival. Thus, the treatment of the neck has become one of the most debated topics in the field of head and neck oncology. Traditionally, treatment of the neck in patients with clinically evident nodal metastasis has been surgical. Nowadays, chemoradiation has been utilized more and more as the primary treatment, aiming at organ and function preservation. Neck dissection for residual or recurrent nodal metastasis, however, is associated with increased incidence of potentially severe complications.
Objectives:
In this work we are aiming at researching the utility of neck dissection during salvage surgery in recurrent head and neck squamous cell carcinoma after failure of organ preservation protocols and to find consensus of different views regarding neck dissection in patients with recurrent head and neck squamous cell carcinoma after chemoradiotherapy.
Search strategy:
We used the following keywords in our search of the National library of medicine database (Medline) available at Pub Med:
Head and neck squamous cell carcinoma, Neck dissection, Neck management, Salvage surgery, Recurrent head and neck squamous cell carcinoma.
The search was limited to articles published in English language, conducted on human subjects in Pubmed (Medline data base). The search was done on 1 / 4 / 2014.
Selection criteria:
We selected articles which include neck management in patients with recurrent head and neck squamous cell carcinoma after being treated with radiochemotherapy.
Data collection and analysis:
For each article the following will be recorded in a data collection form: Study number, Study design, Number of patients, Intervention and outcome measures.
Reporting and interpretation:
The primary search identified 80 articles. Only twenty two (22) of these studies satisfied the inclusion criteria.
Conclusion:
Factors affecting decision making in salvage surgery for neck dissection include:
1.Initial N stage.
2.Recurrent N stage.
3.Recurrent T stage.
4.Primary site (sites rich in lymphatics different than other sites).
5.In the era of chemoradiotherapy; the regimen used in chemoradiotherapy.