Objective: Lateral neck dissection (LND) is important in managing papillary thyroid carcinomas (PTCs). This study aimed to evaluate the relationship between lymph node yield (LNY) for LND and patient outcomes, specifically postoperative serum thyroglobulin levels (sTG) and radioiodine uptake on thyroid scan, and to estimate a threshold LNY to signify adequate LND.
Methods: Patients diagnosed with PTC who underwent LND from 2006 to 2015 at a single institution were included. Linear regression with restricted cubic splines was used to characterize the association of LNY with outcomes. Outcomes were log-transformed to achieve a more symmetric distribution prior to regression. For nonlinear associations, a Monte Carlo Markov Chain procedure was used to estimate a threshold LNY associated with postoperative outcome. This threshold was then used to define high LNY versus low LNY in the subsequent analyses.
Results: In total, 107 adult patients were included. There was a significant relationship between LNY and postoperative sTG level ( = .004), but not radioiodine uptake ( = .64). An LNY of 42.96 was identified, which was associated with the maximum change in sTG level. No association was found between LNY groups (LNY ≥ 43 vs < 43) and radioiodine uptake, risk of complication, or longer operative times (all > .05). High LNY was associated with a decrease in log(sTG) (estimate = -1.855, = .03), indicating that adequacy of LND is associated with an 84.4% decrease in sTG.
Conclusion: These results suggest an association between LNY and postoperative sTG level, with an estimated threshold of 43 nodes. This has implications for adequate therapeutic LND; additional work is needed to validate thresholds for clinical practice.
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The role of lymph node level ratio in predicting prognosis and the benefits of postoperative radiotherapy in patients with pathological N1 stage head and neck squamous cell carcinoma.
Oral Oncol
January 2025
Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, China; State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, China. Electronic address:
Objective: To analyze the role of lymph node level ratio (LNLR) in predicting prognosis and the benefits of postoperative radiotherapy (PORT) in patients with pathological N1 (pN1) head and neck squamous cell carcinoma (HNSCC).
Methods: Patients with pN1 HNSCC from January 2011 to February 2021 were included. Patients were grouped by the LNLR, lymph node yield (LNY), and lymph node ratio (LNR) and were analyzed with the Kaplan-Meier method and multivariate Cox model.
Lymph Node Yield/Ratio, Neutrophil-Lymphocyte Ratio: Prognostic Factors in cN0 Laryngeal Carcinoma.
Laryngoscope
January 2025
Department of Otolaryngology - Head and Neck Surgery, Mansoura University, Mansoura, Egypt.
Objectives: The aim of this study was to investigate the role of lymph node yield (LNY), lymph node ratio (LNR), and neutrophil to lymphocyte ratio (NLR) as prognostic factors, their impact on survival in patients with advanced laryngeal squamous cell carcinoma (LSCC).
Methods: This multicentric retrospective study included 195 patients with clinical N0 advanced laryngeal carcinoma who underwent total laryngectomy and/or total pharyngolaryngectomy over 5 years. The number of lymph nodes extracted (LNY) and the number of positive nodes were counted.
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J Craniomaxillofac Surg
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Department of Otolaryngology - Head and Neck Surgery, Giuseppe Fornaroli Hospital, ASST Ovest Milanese, Magenta, Milano, Italy; Doctoral Degree in Translational Research in Public Health and High Prevalence Diseases, UIB. Universitat de les Illes Balears, Palma de Mallorca, Spain.
Introduction: A growing amount of evidence points at lymph node yield (LNY) and lymph node ratio (LNR) as useful indicators in the prognostic evaluation of patients affected by head and neck squamous cell carcinoma (HNSCC) who require neck dissection. The aim of this study was to assess the importance of LNY and LNR in the prognostic evaluation of head and neck cancer patients.
Materials And Methods: Included studies were those examining LNY and/or LNR in head and neck cancer patients.
Surgical Puzzle: Concurrent Comprehensive Neck Dissection Strategies Unravelling the Mystery of Carcinoma Unknown Primary when Performed with TORS Radical Tonsillectomy and Mucosal Tongue Base Wedge Biopsy in Northern Indian Cohort.
Indian J Otolaryngol Head Neck Surg
December 2024
Department of Otorhinolaryngology and Head-Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
Article Synopsis
- The study focuses on patients with carcinoma of unknown primary who underwent specific surgical procedures, including transoral robotic surgery and neck dissection, to understand the patterns of cervical nodal metastasis.
- It reports a majority of patients presenting clinically as N2b, while histopathological results showed a higher prevalence of N3b disease, indicating some discrepancy between clinical evaluation and actual disease state.
- The most affected lymph node level was consistently found to be level II, with significant findings related to Lymph Node Yield (LNY) and emerging concepts like Lymph Node Ratio (LNR) and Lymph Node Density (LND) to better analyze the metastasis characteristics.
Submandibular Gland-Sparing Technique Versus En-Bloc Level IB Dissection in Oral Cavity Cancers with N0 Neck Status: A Randomized Controlled Trial.
J Otolaryngol Head Neck Surg
November 2024
Department of Otorhinolaryngology-Head & Neck Surgery, AIIMS Rishikesh, Rishikesh, India.
Importance: Metastases to the submandibular gland (SMG) from oral cavity primaries are very rare. Hence, a gland-preserving level IB dissection technique is a feasible option without compromising the lymph node yield (LNY).
Objective: To assess the feasibility and noninferiority of the SMG-preserving dissection technique to the conventional en bloc removal of level IB in terms of LNY in patients with cN0 oral squamous cell carcinoma (OSCC) undergoing elective neck dissection.
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