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Pathology protocol increases lymph node yield in neck dissection for oral cavity squamous cell carcinoma
Author(s) -
Holcomb Andrew J.,
Perryman Mollie,
Goodwin Sara,
Penn Joseph,
Villwock Mark R.,
Bur Andrés M.,
Shnayder Yelizaveta,
Tsue Terance T.,
Woodroof Janet,
Kakarala Kiran
Publication year - 2020
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26343
Subject(s) - neck dissection , lymph node , dissection (medical) , medicine , lymph , adipose tissue , basal cell , carcinoma , pathology , epidermoid carcinoma , radiology , surgery
Background Lymph node yield (LNY) is a proposed quality indicator in neck dissection for oral cavity squamous cell carcinoma (OCSCC). Methods Retrospective series including 190 patients with OCSCC undergoing neck dissection between 2016 and 2018. A change in pathologic grossing protocol was initiated during the study period to assess residual adipose tissue. A generalized linear model was used to assess the impact of multiple variables on LNY. Results Mean LNY was 28.59 (SD = 17.65). The protocol identified a mean of 10.32 lymph nodes per case. Multivariable analysis identified associations between LNY and use of the pathology protocol ( P = .02), number of dissected lymph node levels ( P < .001), presence of pathologic lymph nodes ( P = .002), body mass index ( P = .02), prior neck surgery ( P = .001), and prior neck radiation ( P = .001). Conclusions Assessment of residual adipose tissue within neck dissection specimens improves accuracy of LNY. LNY in neck dissection is influenced by multiple factors including methods of pathologic assessment.