Open cervical lymph node biopsy for head and neck cancers: any benefit?

Adoga, Adeyi A; Silas, Olugbenga A.; Nimkur, Tonga L

doi:10.1186/1758-3284-1-9

Cited by 15 publications

(11 citation statements)

References 9 publications

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“…In general, these patients are considered at low risk of metastatic head and neck cancer; however, we identified three cases of malignant disease in patients between 35 and 40 years of age. Subsequently, this group of patients would have to endure secondary surgery (on an already operated neck) and/or higher doses of radiotherapy due to the risk of residual tumor . In addition, when staging and assessing the patient with a primary tumor, secondary inflammation caused by surgery will also make positron emission tomography/computerized tomography (PET/CT) more difficult to interpret …”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, this group of patients would have to endure secondary surgery (on an already operated neck) and/or higher doses of radiotherapy due to the risk of residual tumor. 14,15 In addition, when staging and assessing the patient with a primary tumor, secondary inflammation caused by surgery will also make positron emission tomography/computerized tomography (PET/CT) more difficult to interpret. 2,16 No international consensus consists regarding guidelines for the preoperative clinical diagnostic workup of cystic masses on the lateral neck with an unknown primary tumor in patients younger than 40 years of age.…”

Section: Discussionmentioning

confidence: 99%

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The true malignancy rate in 135 patients with preoperative diagnosis of a lateral neck cyst

Grønlund¹,

Mey

Andersen

et al. 2016

Laryngoscope Investig Oto

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ObjectiveIn this study, the true malignancy rate in 135 patients with a preoperative tentative diagnosis of a lateral neck cyst (LNC) was assessed. Furthermore, the sensitivity and specificity of fine needle aspiration of suspected LNC were evaluated and the diagnostic delay was analyzed.Study DesignThis study was retrospective in design and included all patients who had undergone surgery for a suspected LNC in four secondary hospitals in the eastern regions of Denmark during the period of 2009 to 2012.MethodsOne hundred thirty‐five patients were identified and included by means of a search strategy for NOMECO surgical procedure codes KENB40A+B in the electronic surgical booking systems. Because the procedure codes also include median neck cysts and fistulas, the latter were excluded manually.ResultsOf the 135 patients preoperatively diagnosed with LNC, a malignant postoperative histopathological diagnosis was revealed in 19 patients (14.4%). Of these, three individuals were between 35 to 40 years of age. In 17 cases, preoperative fine‐needle aspiration biopsy showed benign cytology, whereas histopathology postoperatively proved to be malignant. This renders a sensitivity of 88.8% and a specificity of 60.0% for fine needle aspiration biopsy with regard to LNC diagnostics.ConclusionThis study suggests that, for patients older than 35 years, a cystic lateral neck mass should be considered potentially malignant; by contrast, LNC is a diagnosis of exclusion. Any delay in treatment should be avoided until final histopathological diagnosis has been obtained. Arguably, all patients older than 35 years with a cystic lesion laterally on the neck should be included in the fast‐track cancer referral program.Level of Evidence2b.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The true malignancy rate in 135 patients with preoperative diagnosis of a lateral neck cyst

Grønlund¹,

Mey

Andersen

et al. 2016

Laryngoscope Investig Oto

View full text Add to dashboard Cite

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“…A surgeon who performs open neck mass biopsy in the setting of HNSCC risks local wound complications, distortion of anatomy, and possibly oncologic seeding . The traditional teaching in head and neck surgery is that open biopsies may lead to an increased risk of metastases and decreased survival .…”

Section: Introductionmentioning

confidence: 99%

“…We sought to characterize the current practice of open biopsy for patients presenting with a neck mass. Given the controversial effect of open neck mass biopsy on HNSCC treatment options, we also sought to evaluate treatment received by the group of patients whose HNSCC was diagnosed with an open neck biopsy, in comparison to those who did not receive an open neck mass biopsy …”

Section: Introductionmentioning

confidence: 99%

The current practice of open neck mass biopsy in the diagnosis of head and neck cancer: A retrospective cohort study

Akkina

Kim

Stucken

et al. 2019

Laryngoscope Investig Oto

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Objective To characterize current use of open neck mass biopsy for diagnosis of squamous cell carcinoma in patients presenting with a neck mass. Methods Using the University of Michigan Specialized Program of Research Excellence in Head and Neck Cancer patient database (2008–2014), we reviewed patients’ referral documentation to identify those who received open neck mass biopsies as part of their squamous cell carcinoma diagnosis. We compared subsequent treatment between patients who did and did not receive an open neck mass biopsy. Results Of 940 patients, 50 patients had received open neck mass biopsy leading to squamous cell carcinoma diagnosis. Only 19 of 50 patients (38%) had undergone fine‐needle aspiration prior to open neck mass biopsy. There were no statistically significant differences in treatment or outcomes between patients who did and those who did not receive open neck mass biopsy. Conclusion Optimal care for patients who present with a neck mass is fine‐needle aspiration. Unfortunately, these data show that many patients undergo open neck mass biopsy for diagnosis, often without prior fine‐needle aspirate. Compared to fine‐needle aspiration, open biopsy incurs additional risks of general anesthesia and greater surgical risks. While our data did not find statistically significant differences between treatment offered and outcomes, this small study was not expected to demonstrate a difference in outcomes. Further work is needed to promote the utility of fine‐needle aspiration for diagnosis of neck mass and to discourage use of open neck mass biopsy as a primary diagnostic intervention. Level of Evidence 2c (Outcomes Research)

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“…An important prognostic factor for cancers of the head and neck is the presence or absence, level, and size of metastatic neck disease. The primary site of the tumor is important, with some sites having a higher incidence of metastases than others at presentation [21]. In this study, diagnosed malignant cases were most frequently localized at level V ( n = 23, 52.3%).…”

Section: Discussionmentioning

confidence: 97%

Cytological Findings of Malignant and Benign Head and Neck Masses in Somalia

Baş

2018

Acta Cytologica

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Objective: There are no up-to-date records on head and neck masses (HNMs) in Somalia. This cytological study is the first to demonstrate the benefits and findings of fine-needle aspiration cytology in evaluating HNMs in the adult population of Somalia. Study Design: A total of 116 aspiration samples were taken from different levels of the neck region, except for the thyroid. Cases were classified as salivary gland, lymph node, or soft tissue/cystic lesions. They were classified according to age, gender, and cytological diagnosis. Results: Patients included 54 (46.6%) males and 62 (53.4%) females, with a mean age of 40.6 years. Seventy-two patients (62.1%) had benign lesions, while 44 (37.9%) had malignant lesions. Necrotizing granulomatous lymphadenitis (n = 51, 70.8% of the benign findings) and lymph node metastasis of squamous cell carcinoma (n = 13, 29.5% of the malignant findings) were the most frequent findings. Conclusion: Fine-needle aspiration is a useful procedure in the diagnosis of neck masses. It is a cheap and easy guiding method for diagnosing granulomatous lymphadenitis and advanced-stage metastatic cancers, which are common in this country.

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Open cervical lymph node biopsy for head and neck cancers: any benefit?

Cited by 15 publications

References 9 publications

The true malignancy rate in 135 patients with preoperative diagnosis of a lateral neck cyst

The true malignancy rate in 135 patients with preoperative diagnosis of a lateral neck cyst

The current practice of open neck mass biopsy in the diagnosis of head and neck cancer: A retrospective cohort study

Cytological Findings of Malignant and Benign Head and Neck Masses in Somalia

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