Factors Associated with Lymph Node Count in Mucosal Squamous Cell Carcinoma Neck Dissection

Area of Science:

• Oncology
• Immunology
• Head and Neck Surgery

Background:

• Decreased lymph node count (LNC) in head and neck squamous cell carcinoma (HNSCC) patients after neck dissection (ND) correlates with reduced survival.
• Advanced age and low body mass index (BMI) due to dysphagia are common in HNSCC patients and linked to immune dysfunction.

Purpose of the Study:

• To investigate the relationship between advanced age, low BMI, and LNC in HNSCC patients undergoing ND.
• To identify factors associated with LNC and advanced T-stage in HNSCC.

Main Methods:

• Retrospective review of 247 HNSCC patients who underwent ND between 2006 and 2017.
• Stepwise linear and logistic regression analyses were used to identify factors associated with LNC and T-stage.
• One-way ANOVA compared subgroups based on p16 status.

Main Results:

• Low BMI (<23), advanced age, and extranodal extension (ENE) were independently associated with decreased LNC per neck level.
• Higher T-stage correlated with low BMI after controlling for other factors.
• p16-positive patients were younger, had higher BMI, and higher nodal yield.

Conclusions:

• Patient factors like p16-negative status, advanced age, low BMI, and ENE are linked to lower nodal yield in neck dissections.
• LNC may serve as a metric for anti-tumor immune function, correlating with prognosis and T-stage.