Staff Members - Benha University
Elective Neck Dissection during Surgery for Advanced Glottic Carcinoma with a Clinically Negative Neck: Analysis of Lymph Node Yield and Early Post-Surgical Outcomes.
• 2022
Publication Information
Authors
Ashraf S. El-Hamshary, Mahmoud F. Abdelaziz, Hesham Abdel Samea, Mohammed Hassan,
Eslam F. Abu Shady
Keywords
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Journal
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Publisher
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Pages
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publication.type
Local
Paper Link
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Supplementary Materials
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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 IIIV) 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.
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 IIIV) 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.