Defining a minimum nodal yield for neck dissection in mucosal head and neck squamous cell carcinoma, a systematic review.

BACKGROUND

Analysis of existing literature on lymph node yield (LNY) in neck dissection (ND) for head and neck squamous cell carcinomas (HNSCC) used as a prognostic factor and an indication of treatment adequacy.

METHODS

PubMed, EMBASE and Web of Science databases were systematically searched from January 2010 to June 2023. Inclusion criteria encompassed studies on mucosal HNSCC patients undergoing ND with data on LNY and its association with survival outcomes. The quality assessment followed the REMARK guidelines.

RESULTS

Among 29 included studies, minimum LNY tresholds associated with improved survival outcomes ranged from 10 to 36.5 nodes. The heterogeneity in subsite involvement and cN0/cN + status constituted a challenge in establishing a consensus cutoff. The review highlights the need for standardized surgical techniques and pathological assessments to ensure data comparability.

CONCLUSIONS

LNY is a prognostic indicator and could reflect ND quality in HNSCC.