Pathology protocol increases lymph node yield in neck dissection for oral cavity squamous cell carcinoma

Area of Science:

• Oncology
• Pathology
• Surgical Quality Indicators

Background:

• Lymph node yield (LNY) is a proposed quality indicator for neck dissections in oral cavity squamous cell carcinoma (OCSCC).
• Accurate LNY is essential for staging and treatment planning in OCSCC patients.

Purpose of the Study:

• To evaluate the impact of a modified pathologic grossing protocol on lymph node yield (LNY) in OCSCC neck dissections.
• To identify factors influencing LNY in patients undergoing neck dissection for OCSCC.

Main Methods:

• Retrospective analysis of 190 OCSCC patients undergoing neck dissection (2016-2018).
• Implementation of a new protocol to assess residual adipose tissue in pathology specimens.
• Generalized linear model used to assess variables impacting LNY.

Main Results:

• Mean LNY was 28.59 (SD = 17.65); the protocol identified a mean of 10.32 lymph nodes per case.
• Multivariable analysis revealed significant associations between LNY and the pathology protocol (P=.02), number of dissected lymph node levels (P<.001), positive lymph nodes (P=.002), BMI (P=.02), prior neck surgery (P=.001), and prior neck radiation (P=.001).

Conclusions:

• Assessing residual adipose tissue in neck dissection specimens enhances LNY accuracy.
• Lymph node yield is multifactorial, significantly influenced by pathologic assessment methods and patient-specific variables.