Impacto do esvaziamento cervical radical modificado no número de linfonodos recuperados, recorrência e sobrevida

Köhler, Hugo Fontan; Cunha, Isabella Werneck da; Kowalski, Luiz Paulo

doi:10.1590/s1808-86942010000300017

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…[158][159][160] The reported lymph node yield in a radical neck specimen varies from 1 to 97 lymph nodes. [158][159][160][161][162] Lymph node ratio (or lymph node density) is the ratio of the number of involved lymph nodes to the total number of lymph nodes removed during regional lymph node dissection. Thus, it combines the number of metastatic lymph nodes and the thoroughness of the lymph node dissection.…”

Section: Physician Performance and Prognostic Improvementmentioning

confidence: 99%

Eugene Nicholas Myers' Lecture on Head and Neck Cancer, 2020: The Surgeon as a Prognostic Factor in Head and Neck Cancer Patients Undergoing Surgery*

Kowalski

2023

Int Arch Otorhinolaryngol

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This paper is a transcript of the 29th Eugene N. Myers, MD International Lecture on Head and Neck Cancer presented at the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) in 2020. By the end of the 19th century, the survival rate in treated patients was 10%. With the improvements in surgical techniques, currently, about two thirds of patients survive for > 5 years. Teamwork and progress in surgical reconstruction have led to advancements in ablative surgery; the associated adjuvant treatments have further improved the prognosis in the last 30 years. However, prospective trials are lacking; most of the accumulated knowledge is based on retrospective series and some real-world data analyses. Current knowledge on prognostic factors plays a central role in an efficient treatment decision-making process. Although the influence of most tumor- and patient-related prognostic factors in head and neck cancer cannot be changed by medical interventions, some environmental factors—including treatment, decision-making, and quality—can be modified. Ideally, treatment strategy decisions should be taken in dedicated multidisciplinary team meetings. However, evidence suggests that surgeons and hospital volume and specialization play major roles in patient survival after initial or salvage head and neck cancer treatment. The metrics of surgical quality assurance (surgical margins and nodal yield) in neck dissection have a significant impact on survival in head and neck cancer patients and can be influenced by the surgeon's expertise. Strategies proposed to improve surgical quality include continuous performance measurement, feedback, and dissemination of best practice measures.

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Section: Physician Performance and Prognostic Improvementmentioning

confidence: 99%

Eugene Nicholas Myers' Lecture on Head and Neck Cancer, 2020: The Surgeon as a Prognostic Factor in Head and Neck Cancer Patients Undergoing Surgery*

Kowalski

2023

Int Arch Otorhinolaryngol

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“…Selective neck dissection was first described by Suarez in 1963 (Suarez, 1963). It was then greatly amplified by Bocca and others (Bocca et al, 1984), resulting in current modified neck dissection with comparable oncological efficiency (Kohler et al, 2010; Teymoortash et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Spinal accessory nerve anatomy in the posterior cervical triangle: A systematic review with meta‐analysis

Koliarakis,

Manatakis,

Tsitsipanis

et al. 2023

Clinical Anatomy

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This study aimed to investigate the anatomy of the spinal accessory nerve (SAN) in the posterior cervical triangle, especially in relation to adjacent anatomical landmarks, along with a systematic review of the current literature with a meta‐analysis of the data. Overall, 22 cadaveric and three prospective intraoperative studies, with a total of 1346 heminecks, were included in the analysis. The major landmarks relevant to the entry of the SAN at the posterior border of the SCM muscle (PBSCM) were found to be the mastoid apex, the great auricular point (GAP), the nerve point (NP), and the point where the PBSCM meets the upper border of the clavicle. The SAN was reported to enter the posterior cervical triangle above GAP in 100% of cases and above NP in most cases (97.5%). The mean length of the SAN along its course from the entry point to its exit point from the posterior triangle of the neck was 4.07 ± 1.13 cm. The SAN mainly gave off 1 or 2 branches (32.5% and 31%, respectively) and received either no branches or one branch in most cases (58% and 23%, respectively) from the cervical plexus during its course in the posterior cervical triangle. The major landmarks relevant to the entry of the SAN at the anterior border of the TPZ muscle (ABTPZ) were found to be the point where the ABTPZ meets the upper border of the clavicle and the midpoint of the clavicle, along with the mastoid apex, the acromion, and the transverse distance of the SAN exit point to the PBSCM. The results of the present meta‐analysis will be helpful to surgeons operating in the posterior cervical triangle, aiding the avoidance of the iatrogenic injury of the SAN.

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Surgical Factors Affecting Outcomes in Oral Squamous Cell Carcinoma

Moe

Baker

Ward

2019

Improving Outcomes in Oral Cancer

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Impacto do esvaziamento cervical radical modificado no número de linfonodos recuperados, recorrência e sobrevida

Cited by 6 publications

References 9 publications

Eugene Nicholas Myers' Lecture on Head and Neck Cancer, 2020: The Surgeon as a Prognostic Factor in Head and Neck Cancer Patients Undergoing Surgery*

Eugene Nicholas Myers' Lecture on Head and Neck Cancer, 2020: The Surgeon as a Prognostic Factor in Head and Neck Cancer Patients Undergoing Surgery*

Spinal accessory nerve anatomy in the posterior cervical triangle: A systematic review with meta‐analysis

Surgical Factors Affecting Outcomes in Oral Squamous Cell Carcinoma

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