Impact of Lymph Node Yield on Outcome of Patients with Head and Neck Cancer and pN0 Neck

Abstract

The extent of neck dissection in patients with head and neck cancer (HNSCC) and N0 neck remains controversial. The aim of this study was to evaluate the influence of lymph node yield on overall survival in patients with pathologically node-negative HNSCC. A retrospective analysis was performed on 157 pN0 HNSCC patients undergoing primary surgery with neck dissection between 2000 and 2014. The patients were divided into three groups according to the lymph node count using the optimal cut-points method. The Kaplan-Meier method and log-rank test were used to analyze overall survival and compare survival curves. The lymph node count cut-offs were determined to be 15 and 40. A total of 22 patients had 1-14, 79 patients had 15-39 and 56 patients had 40 or more harvested lymph nodes. There were significant differences in survival between all groups (p=0.001). A lymph node yield of at least 15 nodes was significantly associated with better overall survival in pathologically node-negative patients who underwent surgical resection of HNSCC.