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Do demographics and tumour-related factors affect nodal yield at neck dissection? A retrospective cohort study

Published online by Cambridge University Press:  27 October 2016

R S Lim ,
L Evans ,
A P George ,
N de Alwis ,
P Stimpson ,
S Merriel ,
C E B Giddings ,
B Billah ,
J A Smith  and
A Safdar
...Show all authors
R S Lim*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Monash Health, Melbourne, Australia Department of Surgery (Monash Medical Centre), Victoria, Australia
L Evans
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Monash Health, Melbourne, Australia Department of Surgery (Monash Medical Centre), Victoria, Australia
A P George
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Monash Health, Melbourne, Australia
N de Alwis
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Monash Health, Melbourne, Australia
P Stimpson
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Monash Health, Melbourne, Australia
S Merriel
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Monash Health, Melbourne, Australia
C E B Giddings
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Monash Health, Melbourne, Australia Department of Surgery (Monash Medical Centre), Victoria, Australia
B Billah
Affiliation:
School of Public Health, Monash University, Victoria, Australia
J A Smith
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Monash Health, Melbourne, Australia Department of Surgery (Monash Medical Centre), Victoria, Australia
A Safdar
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Monash Health, Melbourne, Australia Department of Surgery (Monash Medical Centre), Victoria, Australia
E Sigston
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Monash Health, Melbourne, Australia Department of Surgery (Monash Medical Centre), Victoria, Australia
*
Address for correspondence: Dr Rebecca S Lim, Department of Otolaryngology and Head and Neck Surgery, Monash Health, Victoria, Australia E-mail: [email protected]
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Abstract

Background:

Nodal metastasis is an important prognostic factor in head and neck squamous cell carcinoma. This study aimed to determine the average nodal basin yield per level of neck dissection, and to investigate if age, gender, body mass index, tumour size, depth of tumour invasion and p16 status influence nodal yield.

Method:

A retrospective review of 185 patients with head and neck squamous cell carcinoma generated 240 neck dissection specimens.

Results:

The respective mean nodal yields for levels I, II, III, IV and V were 5.27, 9.43, 8.49, 7.43 and 9.02 in non-cutaneous squamous cell carcinoma patients, and 4.2, 7.57, 9.65, 4.33 and 12.29 in cutaneous squamous cell carcinoma patients. Multiple regression analysis revealed that p16-positive patients with mucosal squamous cell carcinoma yielded, on average, 2.4 more nodes than their p16-negative peers (p = 0.04, 95 per cent confidence interval = 0.116 to 4.693). This figure was 3.84 (p = 0.008, 95 per cent confidence interval = 1.070 to 6.605) for p16-positive patients with oral cavity squamous cell carcinoma.

Conclusion:

In mucosal squamous cell carcinoma, p16-positive status significantly influenced nodal yield, with the impact being more pronounced in oral cavity squamous cell carcinoma patients.

Keywords

Squamous Cell CarcinomaNeck DissectionP16 Protein, HumanAge Of OnsetGenderBody Mass Index
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Supplement S1 , January 2017 , pp. S36 - S40
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Jemal, A, Siegel, R, Xu, J, Ward, E. Cancer statistics, 2010. CA Cancer J Clin 2010;60:277–300 CrossRefGoogle ScholarPubMed
2 AIHW and AACR. Cancer in Australia: An Overview 2012, Cancer series no. 74, Cat. no. CAN 70. Canberra: AIHW, 2012 Google Scholar
3 Gil, Z, Carlson, DL, Boyle, JO, Kraus, DH, Shah, JP, Shaha, AR et al. Lymph node density is a significant predictor of outcome in patients with oral cancer. Cancer 2009;115:5700–10CrossRefGoogle ScholarPubMed
4 Patel, SG, Amit, M, Yen, TC, Liao, CT, Chaturvedi, P, Agarwal, JP et al. Lymph node density in oral cavity cancer: results of the International Consortium for Outcomes Research. Br J Cancer 2013;109:2087–95CrossRefGoogle Scholar
5 Marres, CC, de Ridder, M, Hegger, I, van Velthuysen, ML, Hauptmann, M, Navran, A et al. The influence of nodal yield in neck dissections on lymph node ratio in head and neck cancer. Oral Oncol 2014;50:59–64 CrossRefGoogle ScholarPubMed
6 Ebrahimi, A, Clark, JR, Amit, M, Yen, TC, Liao, CT, Kowalski, LP et al. Minimum nodal yield in oral squamous cell carcinoma: defining the standard of care in a multicenter international pooled validation study. Ann Surg Oncol 2014;21:3049–55CrossRefGoogle Scholar
7 Bussu, F, Sali, M, Gallus, R, Petrone, G, Zannoni, GF, Autorino, R et al. Human papillomavirus (HPV) infection in squamous cell carcinomas arising from the oropharynx: detection of HPV DNA and p16 immunohistochemistry as diagnostic and prognostic indicators--a pilot study. Int J Radiat Oncol Biol Phys 2014;89:1115–20CrossRefGoogle ScholarPubMed
8 Lee, MC, Plews, R, Rawal, B, Kiluk, JV, Loftus, L, Laronga, C. Factors affecting lymph node yield in patients undergoing axillary node dissection for primary breast cancer: a single-institution review. Ann Surg Oncol 2012;19:1818–24CrossRefGoogle ScholarPubMed
9 Linebarger, JH, Mathiason, MA, Kallies, KJ, Shapiro, SB. Does obesity impact lymph node retrieval in colon cancer surgery? Am J Surg 2010;200:478–82CrossRefGoogle ScholarPubMed
10 Salman, MC, Usubutun, A, Ozlu, T, Boynukalin, K, Yuce, K. Obesity does not affect the number of retrieved lymph nodes and the rate of intraoperative complications in gynecologic cancers. J Gynecol Oncol 2010;21:24–8CrossRefGoogle Scholar
11 Thompson, RH, Carver, BS, Bosl, GJ, Bajorin, D, Motzer, R, Feldman, D et al. Body mass index is associated with higher lymph node counts during retroperitoneal lymph node dissection. Urology 2012;79:361–4CrossRefGoogle ScholarPubMed
12 Chou, JF, Row, D, Gonen, M, Liu, YH, Schrag, D, Weiser, MR. Clinical and pathologic factors that predict lymph node yield from surgical specimens in colorectal cancer: a population-based study. Cancer 2010;116:2560–70CrossRefGoogle ScholarPubMed
13 Morcos, B, Baker, B, Al Masri, M, Haddad, H, Hashem, S. Lymph node yield in rectal cancer surgery: effect of preoperative chemoradiotherapy. Eur J Surg Oncol 2010;36:345–9CrossRefGoogle ScholarPubMed
14 Aziz, SA, Hsu, T-W, Lu, H-J, Wei, C-K, Yin, W-Y, Chang, C-M et al. Clinical and pathologic factors affecting lymph node yields in colorectal cancer. PLoS One 2013;8:e68526 Google Scholar
15 Luz, DA, Ribeiro, U Jr, Chassot, C, Collet, ES, Cecconello, I, Corbett, CE. Carnoy's solution enhances lymph node detection: an anatomical dissection study in cadavers. Histopathology 2008;53:740–2CrossRefGoogle ScholarPubMed
16 Doll, D, Gertler, R, Maak, M, Friederichs, J, Becker, K, Geinitz, H et al. Reduced lymph node yield in rectal carcinoma specimen after neoadjuvant radiochemotherapy has no prognostic relevance. World J Surg 2009;33:340–7CrossRefGoogle ScholarPubMed
17 Johnstone, PA, Miller, ED, Moore, MG. Preoperative radiotherapy decreases lymph node yield of neck dissections for head and neck cancer. Otolaryngol Head Neck Surg 2012;147:278–80CrossRefGoogle ScholarPubMed