Reyes Camilo, Rios Julian, Groves Michael, Solares C Arturo, Jackson Lana, Byrd J Kenneth
1 Department of Otolaryngology-Head and Neck Surgery, Augusta University, Augusta, GA, USA.
2 Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, GA, USA.
Ear Nose Throat J. 2019 Jun;98(5):283-286. doi: 10.1177/0145561319839790. Epub 2019 Apr 8.
A lymph node yield (LNY) over 20 is considered a quality metric for lateral neck dissection to ensure an oncologic representative sample. Anecdotally, however, LNY in patients undergoing neck dissection after radiation therapy (RT) is lower due to atrophy and fibrosis.
To determine whether preoperative RT decreases LNY in patients with laryngeal cancers undergoing surgery.
Medical record database was queried for patients presenting between 2006 and 2015 with laryngeal cancer. Tabulation was made for location (glottic/supraglottic), stage, and side for the total number of lymph nodes between primary surgery and RT (salvage surgery) groups. Descriptive analysis and a paired Student test were used for statistical analysis.
Fifty-nine patients were included in the study for a total of 98 neck dissections. Twenty-six (44%) patients had primary surgery, and 33 (56%) patients had salvage surgery. The mean left and right total LNY in the salvage surgery group was 27.6 and 29.5, respectively, and 32.2 and 33.7 for the primary surgery group. A difference of 4.5 (left) and 4.3 (right) in LNY between the salvage surgery and primary surgery group was found. A Student test showed no statistically significant difference in LNY between both groups when analyzed per site (glottic and supraglottic), side, and stage (III-IV).
Although patients with prior RT had a lower mean of LNY, our results did not demonstrate a statistically significant difference. Further studies with a larger number of patients are recommended.
淋巴结收获量（LNY）超过20个被视为侧颈清扫术的一项质量指标，以确保获得具有肿瘤代表性的样本。然而，据传闻，接受放射治疗（RT）后行颈清扫术的患者，其LNY因萎缩和纤维化而较低。
确定术前放疗是否会降低接受手术的喉癌患者的LNY。
查询2006年至2015年间就诊的喉癌患者的病历数据库。对原发手术组和放疗后挽救手术组之间的淋巴结总数按部位（声门/声门上）、分期和侧别进行列表。采用描述性分析和配对t检验进行统计分析。
本研究共纳入59例患者，共进行了98次颈清扫术。26例（44%）患者接受了原发手术，33例（56%）患者接受了挽救手术。挽救手术组左侧和右侧的平均总LNY分别为27.6和29.5，原发手术组分别为32.2和33.7。发现挽救手术组和原发手术组之间的LNY在左侧相差4.5，右侧相差4.3。t检验显示，按部位（声门和声门上）、侧别和分期（III-IV期）分析时，两组之间的LNY无统计学显著差异。
虽然先前接受过放疗的患者平均LNY较低，但我们的结果并未显示出统计学显著差异。建议进行更多患者参与的进一步研究。
