Clinicopathological factors affecting lymph node yield in patients undergoing surgery in head-and-neck squamous cell carcinoma in a tertiary care center of North East India

Abstract

Background: Lymph node yield (LNY), number of lymph nodes recovered after neck dissection has been identified as a prognostic indicator for several cancers of non-head and neck sites as well as head-and-neck squamous cell carcinoma (HNSCC). Accurate estimation of LNY has been less evaluated in Indian settings. The purpose of this study was to estimate LNY in HNSCC patients, and to find out their association with clinicopathological factors. Materials and Methods: This was a single-center prospective study conducted on patients diagnosed with HNSCC who had undergone neck dissection with or without primary surgery. Grossing of all surgical specimens was done by guidelines under the College of American Pathologists (November 2021). LNY with their association with other clinic-pathological parameters were analyzed using SPSS software version 21.0. Results: A total of 2692 lymph nodes yielded from 112 samples of neck dissection with the mean LNY of 24.02 ± 9.69. A total of 192 lymph nodes were found to be positive with the mean lymph node ratio of 0.07 ± 2.96. Modified radical neck dissection versus selective node dissection performed cases, poor differentiation of tumor, higher tumor stage, more tumor thickness, and positive nodes for metastasis of squamous cell carcinoma were factors that contributed to higher mean LNY over 24. Conclusions: In an Indian setting, the mean LNY for HNSCC patients undergoing lymph node dissection is 24.02 and the factors such as node positivity, tumor differentiation, tumor stage, and higher tumor thickness affect the estimation of LNY.