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Nodal Yield in Level II-IV Neck Dissections in Head and Neck Squamous Cell Carcinoma
João V Pinto1,2,3, Sofia Pedrosa4, Fernando Vales1,2
1Otorhinolaryngology Department, Unidade Local de Saúde de São João, Porto, PRT.
Cureus
|July 29, 2024
Summary
Lower nodal yield in neck dissections is linked to prior radiotherapy and extranodal invasion, but not survival outcomes. This finding is crucial for understanding selective neck dissection effectiveness.
Area of Science:
- Otorhinolaryngology
- Surgical Oncology
- Head and Neck Cancer Research
Background:
- Selective neck dissection (ND) is a critical procedure for staging and treating head and neck cancers.
- Optimizing nodal yield in level II-IV NDs is essential for accurate staging and treatment planning.
- Factors influencing nodal yield and their impact on patient survival require further investigation.
Purpose of the Study:
- To identify factors associated with nodal yield in level II-IV selective neck dissections (NDs).
- To evaluate the impact of nodal yield on disease-free survival (DFS) and overall survival (OS) in patients undergoing NDs.
Main Methods:
- An observational retrospective study was conducted.
- Included adult patients who underwent level II-IV ND between January 2015 and December 2021.
- Analyzed patient demographics, treatment history, and oncological outcomes.
Main Results:
- A total of 44 patients and 78 NDs were analyzed.
- Lower nodal yield was significantly associated with prior radiotherapy (p=0.042) and extranodal invasion (p<0.001).
- Nodal yield did not show a significant association with five-year DFS (p=0.681) or OS (p=0.888) after adjusting for cN status and age.
Conclusions:
- Reduced nodal yield in level II-IV NDs is significantly correlated with previous radiotherapy and extranodal extension.
- Nodal yield in these dissections does not appear to impact long-term disease-free or overall survival.
- These findings highlight the importance of considering specific patient factors when interpreting nodal yield in selective neck dissections.
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