736 To determine whether comprehensive neck dissec- tion (CND) type 3 could accomplish regional tumor control as well as radical neck dissection (RND) in clinically N0 laryngeal cancer patients, we com- pared the regional recurrence rates of 316 N0 laryngeal cancer patients. In the 316 N0 patients, 486 neck dissections were performed. For 170 patients the dissection was bilateral, and for 146 patients it was unilateral. Of these, 193 were type 3 CNDs, and 293 were RNDs. In 30 (15.5%) of 193 type 3 CNDs and in 53 (18.1%) of 293 RNDs, metastatic lymph nodes were determined histopathologically in neck dissection specimens. The difference in cer- vical lymph node metastasis rates was not statisti- cally significant (P > 0.05). During follow-up, 3 patients who underwent CND type 3 (1.6%) and 12 who underwent RND (4.1%) had regional recur- rences. The difference between recurrence rates was not statistically significant (P > 0.05). A conclu- sion was reached that CND type 3 safely provided regional cancer control in N0 laryngeal cancer and that it might be performed to decrease the morbidity of RND. (Otolaryngol Head Neck Surg 2000;122:736-8.) Neck dissection is performed to control the lymphatic metastases of head and neck cancers. Furthermore, it is frequently used in the surgical treatment of laryngeal cancer, which is the most common cancer of the head and neck region. Radical neck dissection (RND), which was first described by Crile 1 in 1906, has been performed suc- cessfully to remove the cervical lymphatic system en bloc in an effort to control cervical lymphatic metas- tases. However, it has been criticized frequently because of the impact on appearance and function. 2 In the 1960s Bocca and Pignataro 3 popularized comprehensive neck dissection (CND), aiming to diminish the cosmetic and functional loss of RND without risking loss of regional tumor control. However, the use of this technique has led to arguments concerning the ability of CND to con- trol cervical lymphatic metastasis of head and neck cancer. In this study we tried to determine whether regional tumor control could be accomplished with CND type 3, in which the spinal accessory nerve, the internal jugular vein, and the sternocleidomastoid muscle were pre- served, by comparing the regional recurrence rates of clinically N0 laryngeal cancer patients in whom local control was attained. METHODS AND MATERIAL Between 1964 and 1996, 316 N0 patients with laryngeal cancer were treated surgically at Hacettepe University Faculty of Medicine Department of Otolaryngology–Head and Surgery. All patients with neck recurrences in our database file were reviewed retrospectively. Those patients who were N0 and who had neck dissection performed as part of their surgical treatment were entered into the study. Those patients who received radiotherapy to the neck were excluded. N0 status was determined by clinical palpation alone. The palpation was done by senior members of the faculty. Those patients in whom local tumor control was not attained were excluded from the study. Only those cases with local tumor control and neck recurrence were included. At least 2 years of postoperative follow-up were required. We decided to perform total or partial laryngectomy depending on the direct laryngoscopic extension of the lesion, vocal cord, and arytenoid motility, and the general condition of the patient. For N0 cases we performed CND (level I-V) type 3, and for N+ cases we performed en bloc RND with INTERNATIONAL ORIGINAL ARTICLES EUGENE N. MYERS, MD International Editor Comparison of regional recurrence rates of radical and comprehensive neck dissection type 3 in N0 laryngeal cancer TANER YILMAZ, MD, ERG ˙ IN TURAN, MD, A. ¸ SEF ˙ IK HO¸ SAL, MD, and SEFA KAYA, MD, Ankara, Turkey From the Department of Otolaryngology–Head and Neck Surgery, Hacettepe University Faculty of Medicine. Reprint requests: Taner Yılmaz, MD, 12. Sokak No: 8/7, 06490 Bahçelievler, Ankara, Turkey. Copyright © 2000 by the American Academy of Otolaryngology– Head and Neck Surgery Foundation, Inc. 0194-5998/2000/$12.00 + 0 23/77/98319 doi:10.1067/mhn.2000.98319