Nodal yield in selective neck dissection.

CONCLUSION

The total lymph node yield in neck dissection is highly variable and depends on anatomical, surgical and pathological parameters. A minimum yield of six lymph nodes for a selective neck dissection (SND) as recommended in guidelines lies in the lower range of the reported clinical nodal yields. A future application of a lymph node ratio may improve the risk stratification of head and neck cancer patients. However, this will require a higher number of retrieved lymph nodes.

OBJECTIVES

To compare the clinical guideline recommendations for nodal yield in SND with the number of lymph nodes obtained from cadavers and the clinical nodal yield reported in the literature.

METHODS

Lymph nodes retrieved from SND specimens from nine fresh cadavers were quantified histopathologically. The literature on nodal yields reportedly obtained by clinicians performing neck dissections was reviewed. Finally, the discussion makes reference to the six lymph nodes currently recommended in international clinical guidelines.

RESULTS

For clinical SNDs (I-III) the lowest mean nodal yield was 19.4, for SNDs (II-IV) it was 26.4. The cadaver SNDs (I-III and II-IV) yielded 8.8 (range 1-15) and 10.4 nodes (range 1-19), respectively.