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Porcine As a Training Module for Head and Neck Microvascular Reconstruction
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Neck Dissection and Immune Checkpoint Inhibitor Efficacy in Head and Neck Cancer: A Retrospective Study.
Yoh-Ichiro Iwasa1, Kentaro Hori2, Yoh Yokota2
1Department of Otorhinolaryngology-Head and Neck Surgery, Shinshu University School of Medicine, Matsumoto, Japan iwasa@shinshu-u.ac.jp.
Anticancer Research
|January 30, 2026
Summary
Prior neck dissection (ND) in head and neck cancer (HNC) patients receiving immune checkpoint inhibitors (ICIs) was linked to poorer survival in locoregional disease but not distant metastasis. This suggests ND may impair T-cell priming, reducing ICI effectiveness.
Area of Science:
- Oncology
- Immunology
- Surgical Oncology
Background:
- T-cell priming in tumor-draining lymph nodes (TDLNs) is crucial for immune checkpoint inhibitor (ICI) efficacy.
- Neck dissection (ND) in head and neck cancer (HNC) may remove TDLNs, potentially impacting ICI outcomes.
- The clinical relevance of prior ND on subsequent ICI treatment in HNC requires investigation.
Purpose of the Study:
- To determine if prior ND affects treatment outcomes in patients with recurrent or metastatic HNC treated with nivolumab.
- To compare ICI efficacy in HNC patients with and without a history of ND.
Main Methods:
- Retrospective analysis of 54 HNC patients treated with nivolumab.
- Stratification into locoregional disease (LRD) and distant metastasis (DM) cohorts.
- Comparison of outcomes (progression-free survival, overall survival) between patients with and without prior ND within each cohort.
Main Results:
- In the LRD cohort, patients without prior ND had longer median overall survival (18.8 months) compared to those with prior ND (9.8 months; p=0.044).
- Progression-free survival showed a similar trend, favoring patients without prior ND (4.0 months vs. 2.3 months; p=0.089).
- Outcomes in the DM cohort were not significantly affected by prior ND.
Conclusions:
- Prior ND is associated with inferior survival outcomes in HNC patients with locoregional disease treated with nivolumab.
- The findings suggest that ND may reduce ICI efficacy by impairing TDLN function.
- Further research is warranted to explore the impact of surgical interventions on immunotherapy response in HNC.
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