Open cervical lymph node biopsy for head and neck cancers: any benefit?

Area of Science:

• Oncology
• Surgical Pathology

Background:

• Late presentation of head and neck cancers is common, often to general surgeons.
• Initial diagnostic approach frequently involves open cervical lymph node biopsy without prior endoscopic evaluation.
• This practice may influence patient outcomes in head and neck cancer management.

Purpose of the Study:

• To evaluate the impact of open cervical lymph node biopsy on the clinical outcomes of head and neck cancer patients.
• To highlight diagnostic delays and their consequences in head and neck cancer cases.

Main Methods:

• A ten-year retrospective review of head and neck cancer patients at Jos University Teaching Hospital, Nigeria.
• Analysis of patient demographics, initial presentation, diagnostic procedures, and follow-up data.

Main Results:

• 42.7% of 89 head and neck cancer patients presented with cervical lymphadenopathy, initially seen by general surgeons.
• Open cervical lymph node biopsy was performed in 68.4% of these patients, while fine-needle aspiration biopsy (FNAB) was used in 31.6%.
• Significant delays (over 6 months) in referral to otolaryngology were observed, with 9 deaths and 10 patients lost to follow-up.

Conclusions:

• Formal ENT staging and FNAB are recommended for all patients with head and neck lymphadenopathy.
• Avoiding open cervical lymph node biopsy as an initial procedure can help prevent tumor spread and improve prognosis.
• Timely and appropriate diagnostic methods are essential for effective head and neck cancer management.