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Factors influencing nodal yield in neck dissections for head and neck malignancies

Published online by Cambridge University Press:  18 January 2023

J Hintze Open the ORCID record for J Hintze [Opens in a new window] ,
B Lang ,
T Subramaniam ,
N Kruseman ,
E O'Regan ,
S Brennan  and
P Lennon
J Hintze*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, St James's Hospital, Dublin, Ireland Royal College of Surgeons in Ireland, Dublin, Ireland Trinity College Dublin, University of Dublin, Ireland
B Lang
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, St James's Hospital, Dublin, Ireland Royal College of Surgeons in Ireland, Dublin, Ireland Trinity College Dublin, University of Dublin, Ireland
T Subramaniam
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, St James's Hospital, Dublin, Ireland Royal College of Surgeons in Ireland, Dublin, Ireland Trinity College Dublin, University of Dublin, Ireland
N Kruseman
Affiliation:
Department of Histopathology, St James's Hospital, Dublin, Ireland Trinity College Dublin, University of Dublin, Ireland
E O'Regan
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, St James's Hospital, Dublin, Ireland Department of Histopathology, St James's Hospital, Dublin, Ireland Trinity College Dublin, University of Dublin, Ireland
S Brennan
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, St James's Hospital, Dublin, Ireland Department of Radiation Oncology, St James's Hospital, Dublin, Ireland Trinity College Dublin, University of Dublin, Ireland
P Lennon
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, St James's Hospital, Dublin, Ireland Trinity College Dublin, University of Dublin, Ireland
*
Corresponding author: Dr J Hintze, Department of Otolaryngology – Head and Neck Surgery, St James's Hospital, James St, Dublin D08 NHY1, Ireland E-mail: hintzej@tcd.ie
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Abstract

Objective

A standard lateral neck dissection should yield at least 18 lymph nodes. The goal of the present study was to examine what factors might influence the number of lymph nodes retrieved during a neck dissection.

Methods

This was a retrospective cohort study in a tertiary academic referral centre for head and neck oncology. Two hundred and nineteen consecutive neck dissections were examined. Age of the patient and primary site were recorded, along with tumour histology, previous radiotherapy and final nodal count.

Results

The mean age was 62.2 ± 13.0 years. The most common primary site was the oral cavity (38.8 per cent). The mean number of lymph nodes was 30.63 ± 13.9. In total, 17.8 per cent had undergone previous radiotherapy. The mean number of lymph nodes was 33.26 ± 13.27 in patients with no previous radiation exposure and 18.47 ± 9.46 in those with previous radiation treatment.

Conclusion

Lymph node yield from a neck dissection is likely multi-factorial in nature. Previous radiotherapy, the only significant contributor, led to a mean reduction of lymph node yield from 33.3 to 18.5.

Keywords

Neck DissectionRadiotherapyLymph Node Yield
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 8 , August 2023 , pp. 925 - 929
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr J Hintze takes responsibility for the integrity of the content of the paper

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