{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:37:12Z","timestamp":1785850632891,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100016916","name":"Royal Marsden Cancer Charity","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016916","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head & Neck"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n To investigate the outcomes of salvage neck dissection (sND) in recurrent head and neck squamous cell carcinoma (rHNSCC) with clinically positive and negative cervical lymph nodes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Analysis of a retrospective multicentre observational cohort was performed. All patients undergoing sND for cN0 or cN positive disease between 1st January 2016 and 31st December 2022 were included. Survival analysis was stratified according to nodal status and extent of sND.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Data from 235\n sNDs<\/jats:styled-content>\n for\n rHNSCC<\/jats:styled-content>\n after primary radiotherapy were included. Median age was 63 (\n IQR<\/jats:styled-content>\n 57\u201370), and 121\/225 (53.8%) had\n cN0<\/jats:styled-content>\n nodes, whilst 104\/225 (46.2%) were\n cN<\/jats:styled-content>\n +. Superselective, selective, and radical\/modified radical\n sNDs<\/jats:styled-content>\n were performed in 45 (19.3%), 152 (65.2%), and 36 (15.5%). Superselective\n sND<\/jats:styled-content>\n was associated with a shorter median inpatient stay than selective resections (15 vs. 18\u2009days,\n p<\/jats:italic>\n \u2009=\u20090.002). Occult\n pN<\/jats:styled-content>\n + nodal disease was seen in 13\/108 (12%). There were no significant predictors for occult nodal disease. Five\u2010year overall, disease\u2010free, disease\u2010specific, and regional recurrence free survival was 63.3%, 53.0%, 74.2%, and 56.9%. There was no significant difference in any time\u2010to\u2010event endpoint between superselective, selective, and radical\/modified radical\n sND<\/jats:styled-content>\n for\n cN<\/jats:styled-content>\n positive disease, nor was there any significant survival difference between selective\/superselective\n sND<\/jats:styled-content>\n and observation alone in all\n cN0<\/jats:styled-content>\n cancers or in\n cN0<\/jats:styled-content>\n oropharyngeal recurrence only.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Occult disease in cN0 cervical lymph nodes is uncommon and may therefore be safely managed with clinical observation. If the clinical and radiological disease is addressed, survival outcomes are similar across the ND types in cN0 and cN positive disease, implying more conservative excisions do not adversely influence disease control.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/hed.70387","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:14:16Z","timestamp":1784034856000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Salvage Neck Dissection in Recurrent Head and Neck Squamous Cell Carcinoma After Primary Radiotherapy (\n RESCUE<\/scp>\n ): An\n IReC<\/scp>\n Multicentre Consecutive Cohort Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3861-4847","authenticated-orcid":false,"given":"Andrew","family":"Williamson","sequence":"first","affiliation":[{"name":"International Centre for Recurrent Head and Neck Cancer (IReC), Department of Head and Neck Surgery The Royal Marsden Hospital London UK"},{"name":"Institute for Cancer Research London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Burton","sequence":"additional","affiliation":[{"name":"International Centre for Recurrent Head and Neck Cancer (IReC), Department of Head and Neck Surgery The Royal Marsden Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zayn","family":"Rajan","sequence":"additional","affiliation":[{"name":"Research Data & Statistics Unit (RDSU), Royal Marsden Clinical Trials Unit (RM\u2010CTU) London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Kwong","sequence":"additional","affiliation":[{"name":"Research Data & Statistics Unit (RDSU), Royal Marsden Clinical Trials Unit (RM\u2010CTU) London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Tengku","sequence":"additional","affiliation":[{"name":"The Royal Marsden Hospital NHS Greater Glasgow and Clyde Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Anthony","sequence":"additional","affiliation":[{"name":"University of Glasgow Glasgow Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Montgomery","sequence":"additional","affiliation":[{"name":"The Royal Marsden Hospital NHS Greater Glasgow and Clyde Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6389-8397","authenticated-orcid":false,"given":"Yadsan","family":"Devabalan","sequence":"additional","affiliation":[{"name":"Oxford University Hospital NHS Foundation Trust Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart C.","family":"Winter","sequence":"additional","affiliation":[{"name":"Oxford University Hospital NHS Foundation Trust Oxford UK"},{"name":"Nuffield Department of Surgery University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christy","family":"Moen","sequence":"additional","affiliation":[{"name":"South Tyneside and Sunderland NHS Foundation Trust South Tyneside UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Cocks","sequence":"additional","affiliation":[{"name":"South Tyneside and Sunderland NHS Foundation Trust South Tyneside UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi Wei","family":"Liu","sequence":"additional","affiliation":[{"name":"London North West Hospitals London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Kumar","sequence":"additional","affiliation":[{"name":"University Hospitals of Derby and Burton NHS Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun Aadur","family":"Pugazhenthi","sequence":"additional","affiliation":[{"name":"University Hospitals of Derby and Burton NHS Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Mortimore","sequence":"additional","affiliation":[{"name":"University Hospitals of Derby and Burton NHS Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0898-8220","authenticated-orcid":false,"given":"Rasads","family":"Misirovs","sequence":"additional","affiliation":[{"name":"Department of Doctoral Studies Riga Stradins University Riga Latvia"},{"name":"Department of Otorhinolaryngology NHS Lothian Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain J.","family":"Nixon","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology NHS Lothian Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Jia","sequence":"additional","affiliation":[{"name":"University Hospitals Dorset NHS Foundation Trust University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"King","sequence":"additional","affiliation":[{"name":"University Hospitals Dorset NHS Foundation Trust University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Loh","sequence":"additional","affiliation":[{"name":"University Hospitals of Liverpool Group Liverpool UK"},{"name":"Liverpool Head and Neck Centre University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry","family":"Jones","sequence":"additional","affiliation":[{"name":"University Hospitals of Liverpool Group Liverpool UK"},{"name":"Liverpool Head and Neck Centre University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1092-9169","authenticated-orcid":false,"given":"Ben","family":"O'Leary","sequence":"additional","affiliation":[{"name":"International Centre for Recurrent Head and Neck Cancer (IReC), Department of Head and Neck Surgery The Royal Marsden Hospital London UK"},{"name":"Evolution & Translational Genomics The Institute of Cancer Research London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinidh","family":"Paleri","sequence":"additional","affiliation":[{"name":"International Centre for Recurrent Head and Neck Cancer (IReC), Department of Head and Neck Surgery The Royal Marsden Hospital London UK"},{"name":"Institute for Cancer Research London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.0973"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.28045"},{"key":"e_1_2_10_4_1","unstructured":"A.Williamson S.Hargreaves T.Dudding andV.Paleri \u201cQuality of Life Dictates Overall Survival for Recurrent Head and 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