Factors affecting lymph node yield and density in neck dissection

Abstract

Background: Studies suggest that neck dissections with a minimum of 16–18 yielded nodes are associated with better overall survival compared to neck dissections with lower yields. Aims: We aimed to identify factors affecting the lymph node yield and density in patients with oral cavity cancer undergoing elective neck dissection levels 1–3. Materials and methods: Using prospectively registered data, we conducted a population-based cohort study on all patients surgically treated for oral cavity cancer including levels 1–3 neck dissection at our institution from 2018 to 2022. Uni and multivariate analyses were performed to identify factors associated with lymph node yields. Results: In total, 221 patients were included. The mean lymph nodes yield and density were 19 (95%CI 18–20) and 0.12 (95%CI 0.09–0.16), respectively. In multivariate analysis, increasing body weight (p = .034) was positively and previous radiotherapy (p = .006) were negatively correlated with the number of yielded lymph nodes. Lymph node density was positively correlated with body weight (p =.011) and body mass index (p =.032) in univariate analysis. Conclusions and significance: Increasing body weight was positively and previous radiotherapy was negatively correlated to lymph node yield. These factors should be taken into consideration when interpreting the lymph node yield as an indicator of neck dissection quality.