• Jamile Karina Antonio, Marcelo Benedito Menezes, Norberto Kodi Kavabata, Antonio Augusto Tupinambá Bertelli, William Kikuchi, and Antonio José Gonçalves.
• Division of Head and Neck Surgery, Department of Surgery, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, Brazil.
• Sao Paulo Med J. 2008 Mar 6; 126 (2): 112118112-8.

Context And ObjectiveModified radical neck dissection (MRND) is the classical treatment for neck metastases of squamous cell carcinoma (SCC) of the upper aerodigestive tract. However, it may still be accompanied by significant sequelae. One alternative for this treatment would be selective neck dissection (SND), which has a lower incidence of sequelae. The aim of this study was to define which neck metastasis cases would really be suitable candidates for SND.Design And SettingRetrospective clinical-surgical trial at the Division of Head and Neck Surgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP).MethodsWe retrospectively studied 67 patients with SCC of the upper aerodigestive tract, divided into two groups: 1) 47 patients treated by means of SND (node-negative or node-positive), 2) 20 patients treated by means of MRND (all node-positive).ResultsOur results demonstrated that there was no difference between the patients treated with SND or MRND in relation to disease evolution, and that the main prognostic factor was lymph node involvement. We observed that patients with pharyngeal SCC and older patients presented worse evolution and would probably not be suitable candidates for SND.ConclusionsSND may be a good option for treating node-positive necks in selected cases.

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