The posterolateral neck dissection: Technique and results

Objective: To evaluate the effectiveness of the posterolateral neck dissection in providing regional control of metastatic disease to the posterior triangle from head and neck primary tumors as part of a multidisciplinary treatment approach. Design: A case series review of 55 patients treated over a 10-year period from 1982 through 1991 with a minimum of 3 years of follow-up. Factors evaluated included site and histologic type of primary tumors, extent of surgery performed, other therapies provided, pathologic findings, and clinical outcome. Setting: The University of Texas M. D. Anderson Cancer Center, Houston. Patients: Forty-six male and nine female patients were studied. Three of them had bilateral dissections, for a total of 58 operations. Thirty-five were diagnosed as having melanoma; 10, squamous cell carcinoma; and 10, various other histologic types. Intervention: All patients underwent a posterolateral neck dissection, either alone or as part of a multidisciplinary treatment plan. Outcome Measures: Factors reviewed were recurrence, either at the primary site or at a regional site, development of distant metastases, and surgical morbidity. Results: Our review showed that, overall, disease was controlled at the site of the primary tumor in 89% of patients (94% of patients with melanoma) and that regional disease was controlled in 93% of patients (89% of patients with melanoma). Surgical morbidity was minimal. Conclusion: The 'functional' posterolateral neck dissection as practiced at the University of Texas M. D. Anderson Cancer Center is effective surgical therapy that provides control of regional metastatic disease to the posterior neck from head and neck primary tumors.