Minimum Nodal Yield in Oral Squamous Cell Carcinoma: Defining the Standard of Care in a Multicenter International Pooled Validation Study

Ebrahimi, Ardalan; Clark, Jonathan R.; Amit, Moran; Yen, Tzu‐Chen; Liao, Chun Ta; Kowalski, Luiz Paulo; Kreppel, Matthias; Cernea, Cláudio Roberto; Bachar, Gideon; Villaret, Andrea Bolzoni; Fliss, Dan M.; Fridman, Eran; Robbins, K. Thomas; Shah, Jatin P.; Patel, Snehal G.; Gil, Ziv

doi:10.1245/s10434-014-3702-x

Cited by 109 publications

(136 citation statements)

References 22 publications

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“…These conclusions were consistent with the study of Ebrahimi et al 7 In that study, there was no statistical association between LNY and 5-year DSS in patients with pN0. The conclusions of the present study are consistent with the results of Vas Nunes et al, 9 but differ from the reports of Ebrahimi et al 7,8 A plausible explanation for this difference is that the present study used more rigid exclusion criteria (excluding patients with an LNY <10) than previous studies. However, in patients with pN + who underwent only SND, an increased LNY was associated with a significantly higher 5-year DSS risk.…”

Section: Discussionsupporting

confidence: 70%

“…6 However, some investigators have proposed that a high LNY is a positive independent prognostic factor in patients with cN0 HNSCC and that an adequate elective lymphadenectomy should include at least 18 nodes. 7,8 Nonetheless, other investigators believe that LNY is not an important prognostic factor. 9 Currently, the prognostic value of LNY in the Chinese HNSCC population still lacks a clear conclusion from a large clinical study.…”

mentioning

confidence: 99%

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Nodal Yield: Is it a Prognostic Factor for Head and Neck Squamous Cell Carcinoma?

Feng

Huang

et al. 2015

Journal of Oral and Maxillofacial Surgery

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Section: Discussionsupporting

confidence: 70%

mentioning

confidence: 99%

Nodal Yield: Is it a Prognostic Factor for Head and Neck Squamous Cell Carcinoma?

Feng

Huang

et al. 2015

Journal of Oral and Maxillofacial Surgery

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“…11,12 However, to our knowledge, no prospective data has been examined to determine relationships between the number of nodes removed in neck dissection and oncologic outcomes such as locoregional recurrence or survival.…”

Section: Introductionmentioning

confidence: 99%

Establishing quality indicators for neck dissection: Correlating the number of lymph nodes with oncologic outcomes (NRG Oncology RTOG 9501 and RTOG 0234)

Divi

Harris

Harari

et al. 2016

Cancer

100

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Background Prospective quality metrics for neck dissection have not been established for patients with head and neck squamous cell carcinoma. The purpose of this study is to investigate the association between lymph node counts from neck dissection, local-regional recurrence, and overall survival. Methods The number of lymph nodes counted from neck dissection in patients treated on NRG Oncology RTOG trials 9501 and 0234 was evaluated for its prognostic impact on overall survival using a multivariate Cox model adjusted for demographic, tumor, and lymph node data, and stratified by postoperative treatment group. Results 572 patients were analyzed at median follow-up of eight years. 98% of patients were pathologically N+. Median number of lymph nodes recorded on the left and right sides were 24 and 25. Fewer than 18 nodes identified was associated with worse overall survival relative to ≥18 nodes (hazard ratio 1.38, 95%CI 1.09–1.74, p=0.007). The difference appeared to be driven by local-regional failure (HR 1.46, 95%CI 1.02–2.08, p=0.04) but not distant metastases (HR 1.08, 95%CI 0.77–1.53, p=0.65). When analysis was limited to NRG Oncology RTOG 0234 patients, adding p16 status to the model did not affect the hazard ratio for dissected nodes and the effect of nodes was not different by p16 status. Conclusion The removal and identification of 18 or more lymph nodes was associated with improved overall survival and lower rates of local-regional failure, and should be further evaluated as a measure of quality in neck dissections for mucosal squamous cell carcinoma.

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“…A nyirokcsomóhozam prognózisra gyakorolt hatása hasonlónak bizonyult a papillaris pajzsmirigyrákok [13,14], valamint a szájüreg [12,[15][16][17][18], az oropharynx [17] és a hypopharynx [17,19] laphámrákjai esetében is. Egy, a közelmúltban megjelent multicentrikus tanulmány megerősítette a nyirokcsomóhozam független prognosztikai szerepét a cN0 nyaki stádiumú szájüregi laphámrák miatt elektív és szelektív nyaki dissectión át-esett betegeknél is [18].…”

Section: öSszefoglaló Közleményunclassified

“…Egy, a közelmúltban megjelent multicentrikus tanulmány megerősítette a nyirokcsomóhozam független prognosztikai szerepét a cN0 nyaki stádiumú szájüregi laphámrák miatt elektív és szelektív nyaki dissectión át-esett betegeknél is [18].…”

Section: öSszefoglaló Közleményunclassified

A nyaki dissectiók onkológiai hozamának maximalizálása a sebészi morbiditás egyidejű minimalizálása mellett

et al. 2016

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A regionális nyaki lymphadenectomia -elterjedt nevén nyaki dissectio -a fej-nyaki tumorsebészet fontos alapműtéte. Ezen műtét 110 éves evolúciója során a különböző iskolák, nevezéktanok és műtéti technikák keveredése nyomán olyan mértékű zavar alakult ki az irodalomban és a mindennapi szakmai életben, amely szinte lehetetlenné teszi a sebészi és onkológiai eredmények standardizálását és objektív összehasonlítását. Ezt a helyzetet kísérlik meg a szerzők jelen összefoglaló munkájukban közérthetően tisztázni, a multidiszciplináris fej-nyaki terápiás döntésekben részt vevő kollégák kommunikációját megkönnyítendő annak érdekében, hogy a fej-nyaki tumoros betegek számára minden esetben optimális terápiás döntés szülessék. A közlemény történeti és irodalmi áttekintést ad, valamint ismerteti a két legelterjedtebb műtéti technika eredményeinek statisztikai összehasonlítását. A műtéti technika megválasztása szignifikáns hatással van az onkológiai hozamra. A megfelelő sebészi koncepció az onkológiai haszon maximalizálása mellett a betegek életminőségét a lehető legkisebb mértékben befolyásolja, egyrészt a primer sebészi terápiás morbiditás csökkentése, másrészt az adjuváns indikációk optimalizálása révén. Orv. Hetil., 2016, 157(47), 1871-1879. Kulcsszavak: fej-nyaki daganatok, nyaki dissectio, nyirokcsomóhozam, nyaki fascia, sebészi stádiummeghatározásMaximizing nodal yield while minimizing surgical morbidity: the appropriate neck dissection Cervical regional lymphadenectomy, also known as neck dissection, is a fundamental procedure in head and neck surgery. Its evolution over 110 years resulted in a great deal of confusion in the literature and in clinical practice, due to the heterogenicity in training, classification and surgical techniques, which makes outcomes comparability virtually impossible. The authors aim to clarify this situation in a structured manner, in order to facilitate communication among all specialists involved in multidisciplinary head and neck cancer care. The ultimate goal is to make sure that each and every head and neck cancer patient receives their optimal treatment. Review of the history and literature with statistical comparison of the two mainstraim methods regarding their nodal yield results. The applied surgical technique has a significant impact on nodal yield. An appropriate surgical concept achieves maximum oncologic benefit, minimum surgical morbidity with optimized adjuvant indications.

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Minimum Nodal Yield in Oral Squamous Cell Carcinoma: Defining the Standard of Care in a Multicenter International Pooled Validation Study

Cited by 109 publications

References 22 publications

Nodal Yield: Is it a Prognostic Factor for Head and Neck Squamous Cell Carcinoma?

Nodal Yield: Is it a Prognostic Factor for Head and Neck Squamous Cell Carcinoma?

Establishing quality indicators for neck dissection: Correlating the number of lymph nodes with oncologic outcomes (NRG Oncology RTOG 9501 and RTOG 0234)

A nyaki dissectiók onkológiai hozamának maximalizálása a sebészi morbiditás egyidejű minimalizálása mellett

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