Elective neck dissection during surgery for advanced glottic carcinoma with a clinically negative neck: Analysis of lymph node yield and early post-surgical outcomes.

Abdel Samea, Hesham Abdel Rahman; Elhamshary, Ahmed Ashraf Salah; Abdelaziz, Mahmoud Fouad; Abu Shady, Eslam Farid; Hassan, Mohamed El Sayed

doi:10.21608/bmfj.2022.100281.1499

Elective neck dissection during surgery for advanced glottic carcinoma with a clinically negative neck: Analysis of lymph node yield and early post-surgical outcomes.

Document Type : Original Article

Authors

¹ Department of otolaryngology, Faculty of medicine, Benha University, Egypt.

² Department of otolaryngology- Faculty of Medicine- Benha University

³ Department of otolaryngology-Faculty of Medicine - Tanta University

⁴ Department of otolaryngology- Faculty of Medicine - Benha university

10.21608/bmfj.2022.100281.1499

Abstract

Background: Identification of occult nodal metastasis is an important determinant for staging and prognosis, particularly for adjuvant treatment modalities in head and neck cancer. Objectives: to analyze the lymph node yield after elective (selective neck dissection level II-IV) for advanced glottic carcinoma with clinically negative neck and correlate this with early post-surgical outcomes. Patient and methods: This is a case series study conducted on thirty (30) consecutive candidates for total laryngectomy at Otolaryngology departments of both Benha and Tanta University hospitals. Elective bilateral selective neck dissection SND (II-IV) was done in 18 patients (60%).Unilateral SND (II-IV) was done 12 patients (40%). Results: The mean for level II was 9.1, for level III: 11.5 and for level IV: 6.2. The mean nodal yield of SND (II–IV) is 47.7 LNs (range 12-99). There is high significance association between lymph node yield and age (p value=0.001) and with the need of postoperative radiotherapy (p value =0.031). Intraoperative complication; internal jugular vein injured in one case (3.33%). There is significant association between postoperative complications and patient's age (p value = 0.032 ), preoperative tracheostomy (p value =0.002), side of neck dissection (p value =0.004), positive lymph nodes in level II dissection (p value =0.005) and overall total size of the tumor (p value =0.033) when overall total tumor size exceeds 20 cm3. Conclusion: Lymph node yield and ratio directly influence the prognosis and postoperative outcomes and could be considered in staging of those patients.
Key words: Neck dissection, laryngeal carcinoma, lymph node yield.

Keywords