Is there a role for elective neck dissection with salvage laryngectomy? A decision‐analysis model

• DOI: 10.1002/lary.24138
• Publication Date: 2013-05-17T22:14:31Z
• Authors: Ohad Hilly; Sagit Stern; Einav Horowitz; Moshe Leshno; Raphael Feinmesser
• Keywords: Neck dissection

Elective neck dissection for the clinically negative is often a matter of debate. A decision-analysis model that was published in 1994 established widely accepted principle warranted when risk occult metastases higher than 20%. The aim present study to build specific and up-to-date determine need elective during salvage laryngectomy after chemoradiation failure identify variables effect decision.Decision-analysis model.A performed compare outcome patients total with without an dissection. Probabilities expected utilities were derived from available literature construct model. Monte Carlo simulation sensitivity analysis used calculate our models' outcomes influence most, respectively.When calculating results data, we found not laryngectomy. Optimal decision be sensitive by two variables: 1) probability cure dissection, 2) regional-only recurrence In multiway analysis, only rate exceeded 82%, adding preferred decision. practice, rates are around 50% 65%.Based on model, do recommend routine chemoradiation.