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Minimum lymph node yield in elective level I-III neck dissection.

Jason D Pou1, Blair M Barton1, Claire M Lawlor1

  • 1Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana.

The Laryngoscope
|March 9, 2017
PubMed
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This summary is machine-generated.

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For head and neck squamous cell carcinoma, a minimum lymph node yield (LNY) of 18 nodes in elective level I-III neck dissections is recommended to ensure adequate staging and capture of occult disease.

Area of Science:

  • Oncology
  • Head and Neck Surgery
  • Pathology

Background:

  • Adequate lymph node yield (LNY) is crucial for staging head and neck squamous cell carcinoma.
  • Unlike other dissections, no definitive LNY exists for elective level I-III neck dissections.

Purpose of the Study:

  • To determine the minimum LNY for elective level I-III neck dissection to reliably detect positive lymph nodes.

Main Methods:

  • Retrospective analysis of 118 elective level I-III neck dissections for head and neck squamous cell carcinoma (2004-2015).
  • Exclusion of patients with unknown lymph node counts.
  • Data collected included age, gender, tumor subsite, stage, and LNY.

Main Results:

  • Mean LNY was 21.15 nodes.
Keywords:
Lymph node yieldlevel I-III neck dissectionsupraomohyoid

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  • Metastatic disease was found in 24.5% of cases.
  • The highest proportion of positive nodes (36%) was observed in dissections yielding 18-24 nodes, significantly more than those with <18 nodes (P=.044).

    • Conclusions:

    • A minimum LNY of 18 lymph nodes for elective level I-III neck dissection may be considered adequate.
    • This yield aids in the reliable detection of occult metastatic disease.