Objectives/Hypothesis: To estimate the incidence of subclinical nodal disease at the time of
isolated local recurrence (LR) after chemoradiotherapy for an initially staged N0 head and
neck squamous cell carcinoma. Methods: We retrospectively reviewed 44 patients who
underwent salvage surgery with or without elective neck dissection (END) for an isolated LR
between 1997 and 2010. The incidence of subclinical nodal disease was determined from
the pathology reports and from clinical neck failures. Results: Thirty patients received END …

Results The median living follow-up for the entire study population was 33.4 months (range,
2.1–118.7). For those who received an END at time of salvage surgery and non-END
cohorts, the median living follow-up were 33.1 (range, 2.2–118.7) and 37.4 months (range,
2.1–113.4), respectively. Thirty patients received END at the time of salvage surgery (17 with
bilateral and 13 with ipsilateral END). Fourteen patients received salvage surgery without
END. The overall incidence of subclinical nodal metastasis was 7%(3/44 patients). In the …