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An Above-Average Lymph Node Yield Removed During Curative Neck Dissection in Advanced Head and Neck Squamous Cell
Miray-Su Yılmaz Topçuoğlu1, Thiemo Seidler1, Patrick J Schuler1
1Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty of Heidelberg, University Hospital Heidelberg, 69120 Heidelberg, Germany.
Cancers
|January 10, 2026
Summary
Maximizing lymph node yield during neck dissection, particularly on the contralateral side, significantly improves survival for advanced head and neck squamous cell carcinoma (HNSCC) patients. Thorough dissections enhance patient outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Cancer Research
Background:
- Lymph node yield in neck dissection is crucial for advanced head and neck squamous cell carcinoma (HNSCC) patient outcomes.
- Optimizing resection while minimizing surgical risk is a key challenge in HNSCC treatment.
Purpose of the Study:
- To retrospectively investigate the impact of lymph node yield on survival in patients with advanced HNSCC.
- To determine if the extent and thoroughness of neck dissection influence patient prognosis.
Main Methods:
- Analysis of 234 advanced HNSCC patients treated between 1997-2018 at a German university hospital.
- Inclusion of patient data, tumor characteristics, and neck dissection extent.
- Statistical analysis using multivariate Cox proportional hazards models and Kaplan-Meier analyses.
Main Results:
- Above-average lymph node yield correlated with improved survival compared to average or below-average yields.
- Contralateral neck dissection with higher lymph node counts showed a significant survival benefit (10.7-fold).
- Higher lymph node yield was associated with better overall survival across bilateral and ipsilateral dissections.
Conclusions:
- Thorough neck dissection, aiming for a higher lymph node yield, can significantly improve survival in advanced HNSCC.
- Inclusion of contralateral neck dissection, when performed meticulously, is associated with better patient prognosis.
- Optimizing surgical technique to maximize lymph node retrieval is recommended for advanced HNSCC management.
