The treatment failures after radical neck dissection (RND) are recurrence of ipsilateral neck, metastasis of the contralateral neck and distant metastasis, all of which are difficult to treat and have poor prognosis.
Studying these failures in 76 patients of squamous cell carcinomas after RND performed in head and neck cancers, we have some results.
The primary disease controlled group (57 patients) has 89.5% survival rate.The incidence of failures is relatively few.Contralateral neck metastases are found in 12.3% of this group, but they have relatively good prognosis, showing 71.4% survival rate.
The primary disease uncontrolled group (19 patients) took unfavourable clinical course and their survival rate was 26.3%.The occurrence of failures was much greater than the primary disease controlled group.
The prognosis of both the recurrence of ipsilateral neck and the distant metastasis are fairy poor in both groups.It is no exaggeration to say that they are an ominus, mortal signs.
According to these results, the prognosis after RND directely depends upon whether the primary disease is controlled or not.
The degree of pathological invasion in involved lymph nodes relates to the recurrence rate of primary disease and seems to relate mainly to the incidence of recurrence of ipsilateral neck.
