The Association between Cervical Lymph Node Dissection and Dementia: A Retrospective Analysis

Abstract

BackgroundDementia, characterized by memory loss and cognitive impairment, significantly impacts individuals and society. Our research focuses on cervical lymph nodes, crucial for CNS lymphatic drainage, in the context of dementia. We hypothesize that head and neck cancer (HNC) patients undergoing cervical lymph node dissection (CLND) may have an increased dementia risk due to obstructed lymphatic pathways. MethodsWe conducted a retrospective analysis of electronic medical records from patients over 60 diagnosed with HNC who underwent CLND between March 2007 and April 2023. We collected demographic data, calculated dementia incidence rates, and compared parameters between patients with and without dementia. ResultsAmong 251 HNC patients who underwent CLND, 234 were male and 17 were female. Nine male patients developed dementia within an average of 50.1 ± 35.3 months post-surgery. The dementia incidence rate was 0.7 per 100 patient-years, with a cumulative incidence of 10.34% over 8.6 years. CLND patterns were associated with dementia (p = 0.028), with bilateral supraomohyoid neck dissection (SOHND)/modified radical neck dissection (MRND) and unilateral MRND combined with any neck dissection type on the other side presenting higher risks than unilateral MRND/SOHND (p = 0.016). ConclusionHNC patients undergoing bilateral and comprehensive lymph node dissection show a higher dementia risk, highlighting the importance of the neck’s lymphatic role in brain health. These findings may guide future surgical practices.