Neck dissection in the combined-modality therapy of patients with locoregionally advanced head and neck cancer

Purpose. The purpose of this study was to eval- uate the role of neck lymph node (ND) in the combined dis- section modality therapy for locoregionally advanced head and neck cancer. Methods. We identified patients with N2-N3 head and neck cancers who were enrolled in three consecutive multicenter phase II studies of concurrent chemoradiotherapy utilizing 5- fluorouracil and hydroxyurea on an alternate-week schedule with radiotherapy twice daily plus either cisplatin (C-FHX) or pacli- taxel (T-FHX). Patients with unknown primary tumors, nasophar- yngeal or paranasal sinus primaries, nonsquamous histology, progression or death during therapy, or incomplete therapy were excluded. Results. A total of 131 patients were analyzed. Seventy-nine percent had N2 stage. ND was performed in 92 patients (70%), either prior to enrollment (n = 31) or after chemoradiotherapy (n = 61). With a median follow-up of 4.6 years, the 5-year loco-