Evidence map›Paper›PMID 40182665›Full record

ReviewLaryngoscope investigative otolaryngology2025

Salvage Laryngectomy in Clinically N0 Patients: Is Elective Neck Dissection Indicated?

Mazin Merdad, Nada Al Taylouni

Abstract readReview
In one paragraph

Review in Laryngoscope investigative otolaryngology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Mazin MerdadDepartment of Otolaryngology-Head and Neck Surgery King Abdulaziz University Jeddah Saudi Arabia.
Nada Al TaylouniMedical Resident King Abdullah Medical Complex Jeddah Saudi Arabia.ORCID https://orcid.org/0000-0002-0485-0796

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: This systematic review and meta-analysis investigated the role of elective neck dissection (END) in the salvage management of clinically N0 necks. Data Sources: PubMed/Medline, Google Scholar, and the Cochrane Library were systematically searched for relevant studies. Methods: Both electronic and manual search strategies were conducted within the abovementioned databases and included articles and reviews to find the relevant studies. Rates of occult nodal metastasis, survival outcomes, and postoperative complications were analyzed in N0 patients undergoing salvage laryngectomy with END. Fixed and random effects models were used to calculate pooled estimates of overall survival metastasis rates with 95% confidence intervals, and heterogeneity was assessed using tau Results: The included eight studies reported occult metastasis rates ranging from 4% to 10% in clinically N0 necks post-radiotherapy. Overall survival was approximately 52%, with mixed evidence on the survival advantage of END. Disease-free survival and recurrence-free survival rates ranged from 71.7% to 95.5% at 5 years. Complication rates associated with END were high, with up to 47.4% of patients experiencing postoperative morbidity. The metastasis rate was 10%-13% highlighting the ability of END to detect occult metastases. Conclusion: The survival benefits of END are not consistently supported by current evidence, while the significant morbidity associated with the procedure raises concerns about its routine use. A conservative approach may be more appropriate for clinically node-negative patients, particularly when weighed against the elevated risks of complications. END demonstrates moderate overall survival rates and an ability to detect occult metastases, but its role in improving long-term outcomes remains unclear. Larger prospective studies and randomized trials are needed to better define the indications and outcomes of END in the salvage management of clinically N0 necks.

Indexed as

elective necklaryngectomyneck dissectionoccult nodal

Identifiers

PMID40182665
PMCPMC11967246

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.