Preoperative Radiotherapy Decreases Lymph Node Yield of Neck Dissections for Head and Neck Cancer

Abstract

Objective

Determine if preoperative radiation therapy (RT) decreases the lymph node (LN) yield found at the time of neck dissection.

Study Design

Cross-sectional analysis of Surveillance, Epidemiology, and End Results (SEER) database.

Methods

The SEER database was queried for patients presenting between 1998 and 2002 with tonsil, oropharynx, hypopharynx, and laryngeal primary lesions. Tabulation was made by LNs examined, type of neck dissection performed, and timing of RT. Data from 2441 patients were retrieved. Descriptive statistics were used.

Results

One hundred sixty-one patients with RT preoperatively had a median of 20 LNs sampled (0-72). In total, 647 patients receiving no RT had a median of 27 LNs examined (0-88), and 1643 patients receiving RT postoperatively had a median of 29 (0-89). Mann-Whitney P = .02 was derived for RT preoperatively compared with no RT/RT postoperatively.

Conclusion

In the head and neck, preoperative RT contributes to lower neck dissection LN yield.

Keywords

head and neck cancer lymph nodes neck dissection SEER

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References

Jeong

Lim

. Influence of preoperative chemoradiotherapy on the number of lymph nodes retrieved in rectal cancer. Ann Surg. 2010;252:336-340.

Bhattacharyya

. The effects of more conservative neck dissections and radiotherapy on nodal yields from the neck. Arch Otolaryngol Head Neck Surg. 1998;124:412-416.

Zarbo

Crissman

. In: Jacobs

Crissman

Valeriote

eds. Head and Neck Cancer: Scientific Perspectives in Management and Strategies for Cure. New York, NY: Elsevier Science; 1987:79-93.

Moore

Bhattacharyya

. Effectiveness of chemotherapy and radiotherapy in sterilizing cervical nodal disease in squamous cell carcinoma of the head and neck. Laryngoscope. 2005;115:570-573.

Carter

Bliss

Soo

K-C

O’Brien

. Radical neck dissections for squamous carcinomas: pathological findings and their clinical implications with particular reference to transcapsular spread. Int J Radiat Oncol Biol Phys. 1987;13:825-832.

Friedman

Lim

Dickey

. Quantification of lymph nodes in selective neck dissection. Laryngoscope. 1999;109:368-370.

Shvero

Koren

Marshak

. Histological changes in the cervical lymph nodes after radiotherapy. Oncol Rep. 2001;8:909-911.

Evans

Barton

Rees

Stamatakis

Karandikar

. The impact of surgeon and pathologist on lymph node retrieval in colorectal cancer and its impact on survival for patients with Dukes’ stage B disease. Colorectal Dis. 2008;10:157-164.

Mekenkamp

van Krieken

Marjinen

van de Velde

Nagtegaal

. Lymph node retrieval in rectal cancer is dependent on many factors—the role of the tumor, the patient, the surgeon, the radiotherapist, and the pathologist. Am J Surg Pathol. 2009;33:1547-1553.