Impact of lymph node yield in cutaneous squamous cell carcinoma of the head and neck
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Updated: Oct 30, 2026
Quantification of Tumor Cell Adhesion in Lymph Node Cryosections
Published on: February 9, 2020
Carly A Fassler1, Andrew Meci2, Shivam Patel3
1Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Objectives:
To determine the impact of lymph node yield (LNY) in patients undergoing neck dissection (ND) at the time of wide local excision (WLE) for head and neck cutaneous squamous cell carcinoma (HNCSCC).
Study Design:
Retrospective cohort study.
Setting:
Two academic medical centers.
Methods:
Retrospective review of LNY and oncologic outcomes in patients undergoing WLE with ND at two academic centers.
Results:
A total of 192 total patients who underwent WLE with concurrent ND were included. The cohort was stratified by clinical lymph node status, with half (n = 96) of patients being clinically N+ (cN+) and half (n = 96) of patients being clinically N0 (cN0) at presentation. Total LNY was not predictive of overall survival (OS) when examined as a continuous measure for either group. LNY ≥24 was associated with poorer OS (p = 0.031) and poorer DFS (p = 0.007) for cN0 patients. There was no difference in OS or DFS at any LNY cutoff for cN+ patients on threshold analysis. On multivariate Cox proportional hazard regression model, risk of recurrence was greater in cN0 patients with LNY ≥ 24 (HR = 5.4, 95%CI 2.08-14.16, p < 0.001), controlling for LVI, pathological T stage, and clinical center.
Conclusion:
Increasing LNY was associated with poorer OS and DFS, primarily in cN0 HNCSCC patients. LNY may not be a singular predictor of survival, but should be considered in conjunction with other adverse risk factors.
