Lymph Node Yield in Therapeutic Neck Dissection: Impact of Dissection Levels and Prior Radiotherapy

Dylan Lippert; Phat Dang; Donald Cannon; Paul M Harari; Timothy M McCulloch; Matthew R Hoffman; Gregory K Hartig

doi:10.1177/0003489417730839

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Lymph Node Yield in Therapeutic Neck Dissection: Impact of Dissection Levels and Prior Radiotherapy

Journal article

Peer reviewed

Lymph Node Yield in Therapeutic Neck Dissection: Impact of Dissection Levels and Prior Radiotherapy

Dylan Lippert, Phat Dang, Donald Cannon, Paul M Harari, Timothy M McCulloch, Matthew R Hoffman and Gregory K Hartig

Annals of otology, rhinology & laryngology, Vol.126(11), pp.762-767

11/2017

DOI: 10.1177/0003489417730839

PMID: 28948832

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Abstract

Lymph node yield in therapeutic neck dissection is clinically significant and incompletely studied. We quantified node yield based on extent of neck dissection and presence of preoperative radiation. We also evaluated factors affecting incidence of extracapsular spread (ECS). Retrospective review of 499 patients undergoing therapeutic neck dissection; 414 patients met inclusion criteria and were divided into 2 groups: neck dissection alone or before radiation (surgery first: 280 patients; 385 dissections) and primary radiation before surgery (radiation first: 134 patients; 157 dissections). Node yield relative to levels dissected and incidence of ECS were examined. Dissection-specific node yield was greater in the surgery first group for dissection of levels I-V (31.1 ± 16.7 vs 24.0 ± 14.7, P < .001) and levels II-V (26.7 ± 14.4 vs 21.1 ± 10.7). Extracapsular spread incidence was 32.1% (98/305) in the surgery first group and 15.4% (23/149) in the radiation first group ( P < .001). This study clarifies anticipated node yield based on number of levels dissected and presence of preoperative radiation. Node yield and incidence of ECS are lower in patients undergoing preoperative radiation.

Carcinoma, Squamous Cell - pathology

Carcinoma, Squamous Cell - radiotherapy

Carcinoma, Squamous Cell - surgery

Female

Head and Neck Neoplasms - pathology

Head and Neck Neoplasms - radiotherapy

Head and Neck Neoplasms - surgery

Humans

Lymph Nodes - pathology

Lymph Nodes - surgery

Lymphatic Metastasis

Male

Middle Aged

Neck Dissection

Radiotherapy, Adjuvant

Retrospective Studies

Details

Title: Subtitle: Lymph Node Yield in Therapeutic Neck Dissection: Impact of Dissection Levels and Prior Radiotherapy
Creators: Dylan Lippert - University of Wisconsin–Madison
Phat Dang - University of Wisconsin–Madison
Donald Cannon - University of Wisconsin–Madison
Paul M Harari - University of Wisconsin–Madison
Timothy M McCulloch - University of Wisconsin–Madison
Matthew R Hoffman - University of Wisconsin School of Medicine and Public Health
Gregory K Hartig - University of Wisconsin–Madison
Resource Type: Journal article
Publication Details: Annals of otology, rhinology & laryngology, Vol.126(11), pp.762-767
DOI: 10.1177/0003489417730839
PMID: 28948832
ISSN: 0003-4894
eISSN: 1943-572X
Language: English
Date published: 11/2017
Academic Unit: Otolaryngology
Record Identifier: 9984366379602771

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