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Prognostic value of the nodal yield in elective neck dissections in patients with head and neck carcinomas

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Abstract

Purpose

The objective of this study is to assess the prognostic capacity of the nodal yield in elective neck dissections performed in patients with head and neck squamous cell carcinomas (HNSCC) without clinical or radiological evidence of regional involvement (cN0) at the time of diagnosis.

Methods

Retrospective study including 647 patients with HNSCC treated with an elective neck dissection.

Results

Patients with < 15 dissected nodes (n = 172, 26.6%) had a 5-year disease-specific survival of 64.9% (95% CI: 57.3–72.5%), while for patients with ≥ 15 dissected nodes (n = 475, 73.4%), it was of 81.9% (95% CI: 78.4–85.4%) (P = 0.0001). The nodal yield category had prognostic capacity on the disease-specific survival in patients with tumors located in the oral cavity (P = 0.001), the oropharynx (P = 0.023) and the hypopharynx (P = 0.034), while for patients with tumors located in the larynx, no significant differences appeared (P = 0.779). Differences in regional recurrence-free survival were also observed based on the nodal yield category in patients with extra-laryngeal tumors (5-year regional recurrence-free survival of 81.0% in patients with < 15 dissected nodes vs 89.0% in patients with ≥ 15 dissected nodes; P = 0.046).

Conclusion

The nodal yield in elective neck dissections in patients without evidence of lymph node disease (cN0) had prognostic capacity depending on the location of the primary tumor. For tumors located in the larynx, the number of dissected nodes did not significantly influence the prognosis. For tumors located in the oral cavity, oropharynx or hypopharynx, patients with < 15 dissected nodes had a disease-specific mortality 2.9 times higher than patients with ≥ 15 dissected nodes.

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Data availability

Data available from the hospital software, SAP.

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Funding

This work was supported by grants from Plan Estatal de I + D + I of the Instituto de Salud Carlos III (FIS PI19/01,661). Fondo Europeo de Desarrollo Regional (FEDER), A Way to Build Europe.

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Authors and Affiliations

  1. Servicio de Otorrinolaringología. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

    Xavier León, María del Prado Venegas, Maria Casasayas, Camilo Rodríguez, Eduard D. Neumann, Anna Holgado & Miquel Quer

  2. Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain

    Xavier León & Miquel Quer

Authors
  1. Xavier León
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  2. María del Prado Venegas
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  3. Maria Casasayas
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  4. Camilo Rodríguez
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  5. Eduard D. Neumann
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  6. Anna Holgado
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  7. Miquel Quer
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All authors contributed in the writing or editing of the article.

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Correspondence to Maria Casasayas.

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The authors declare no conflict of interest.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional, regional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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León, X., Venegas, M.P., Casasayas, M. et al. Prognostic value of the nodal yield in elective neck dissections in patients with head and neck carcinomas. Eur Arch Otorhinolaryngol 279, 883–889 (2022). https://doi.org/10.1007/s00405-021-06819-0

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  • DOI: https://doi.org/10.1007/s00405-021-06819-0

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