Impact of Lymph Node Yield in Patients Undergoing Total Laryngectomy and Neck Dissection

Objectives: To determine the impact of lymph node yield (LNY) in patients undergoing neck dissection at the time of total laryngectomy (TL). To determine the impact of radiation therapy (RT) on LNY. Methods: Retrospective review of LNY and clinical outcomes in 232 patients undergoing primary or salv...

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Published in:Annals of otology, rhinology & laryngology rhinology & laryngology, 2021-06, Vol.130 (6), p.591-601
Main Authors: Topf, Michael C., Philips, Ramez, Curry, Joseph, Magana, Linda C., Tuluc, Madalina, Bar-Ad, Voichita, Keane, William, Goldman, Richard A., Luginbuhl, Adam, Cognetti, David
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Disease-Free Survival
Female
Humans
Laryngeal Neoplasms - mortality
Laryngeal Neoplasms - radiotherapy
Laryngeal Neoplasms - surgery
Laryngectomy
Lymph Node Ratio
Lymphatic Metastasis
Male
Margins of Excision
Middle Aged
Neck Dissection
Neoadjuvant Therapy
Radiotherapy, Adjuvant
Retrospective Studies
Salvage Therapy
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container_title Annals of otology, rhinology & laryngology
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creator Topf, Michael C.
Philips, Ramez
Curry, Joseph
Magana, Linda C.
Tuluc, Madalina
Bar-Ad, Voichita
Keane, William
Goldman, Richard A.
Luginbuhl, Adam
Cognetti, David
description Objectives: To determine the impact of lymph node yield (LNY) in patients undergoing neck dissection at the time of total laryngectomy (TL). To determine the impact of radiation therapy (RT) on LNY. Methods: Retrospective review of LNY and clinical outcomes in 232 patients undergoing primary or salvage total laryngectomy (TL) with ND. Results: Preoperative RT significantly decreased mean LNY from 31.7 to 23.9 nodes (P 
doi_str_mv 10.1177/0003489420964824
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To determine the impact of radiation therapy (RT) on LNY. Methods: Retrospective review of LNY and clinical outcomes in 232 patients undergoing primary or salvage total laryngectomy (TL) with ND. Results: Preoperative RT significantly decreased mean LNY from 31.7 to 23.9 nodes (P &lt; .001). In primary TL patients, age (P &lt; .001) and positive margins (P = .044) were associated with decreased OS. In salvage TL patients, only positive margins was associated with poorer OS (P = .009). No LNY cutoff provided significant OS or DFS benefit. Conclusions: Radiotherapy significantly reduces LNY in patients undergoing TL and ND. Within a single institution cohort, positive margins, but not LNY, is associated with survival in both primary and salvage TL patients. Level of Evidence: 4</description><identifier>ISSN: 0003-4894</identifier><identifier>EISSN: 1943-572X</identifier><identifier>DOI: 10.1177/0003489420964824</identifier><identifier>PMID: 33412910</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Disease-Free Survival ; Female ; Humans ; Laryngeal Neoplasms - mortality ; Laryngeal Neoplasms - radiotherapy ; Laryngeal Neoplasms - surgery ; Laryngectomy ; Lymph Node Ratio ; Lymphatic Metastasis ; Male ; Margins of Excision ; Middle Aged ; Neck Dissection ; Neoadjuvant Therapy ; Radiotherapy, Adjuvant ; Retrospective Studies ; Salvage Therapy</subject><ispartof>Annals of otology, rhinology &amp; laryngology, 2021-06, Vol.130 (6), p.591-601</ispartof><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-e8833959fd06f297cf8e06f733eb0644fe1080f488f7e1696e1103550116c8b33</citedby><cites>FETCH-LOGICAL-c337t-e8833959fd06f297cf8e06f733eb0644fe1080f488f7e1696e1103550116c8b33</cites><orcidid>0000-0002-1022-4417 ; 0000-0003-3899-6678</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,79364</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33412910$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Topf, Michael C.</creatorcontrib><creatorcontrib>Philips, Ramez</creatorcontrib><creatorcontrib>Curry, Joseph</creatorcontrib><creatorcontrib>Magana, Linda C.</creatorcontrib><creatorcontrib>Tuluc, Madalina</creatorcontrib><creatorcontrib>Bar-Ad, Voichita</creatorcontrib><creatorcontrib>Keane, William</creatorcontrib><creatorcontrib>Goldman, Richard A.</creatorcontrib><creatorcontrib>Luginbuhl, Adam</creatorcontrib><creatorcontrib>Cognetti, David</creatorcontrib><title>Impact of Lymph Node Yield in Patients Undergoing Total Laryngectomy and Neck Dissection</title><title>Annals of otology, rhinology &amp; laryngology</title><addtitle>Ann Otol Rhinol Laryngol</addtitle><description>Objectives: To determine the impact of lymph node yield (LNY) in patients undergoing neck dissection at the time of total laryngectomy (TL). To determine the impact of radiation therapy (RT) on LNY. Methods: Retrospective review of LNY and clinical outcomes in 232 patients undergoing primary or salvage total laryngectomy (TL) with ND. Results: Preoperative RT significantly decreased mean LNY from 31.7 to 23.9 nodes (P &lt; .001). In primary TL patients, age (P &lt; .001) and positive margins (P = .044) were associated with decreased OS. In salvage TL patients, only positive margins was associated with poorer OS (P = .009). No LNY cutoff provided significant OS or DFS benefit. Conclusions: Radiotherapy significantly reduces LNY in patients undergoing TL and ND. Within a single institution cohort, positive margins, but not LNY, is associated with survival in both primary and salvage TL patients. 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laryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Topf, Michael C.</au><au>Philips, Ramez</au><au>Curry, Joseph</au><au>Magana, Linda C.</au><au>Tuluc, Madalina</au><au>Bar-Ad, Voichita</au><au>Keane, William</au><au>Goldman, Richard A.</au><au>Luginbuhl, Adam</au><au>Cognetti, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Lymph Node Yield in Patients Undergoing Total Laryngectomy and Neck Dissection</atitle><jtitle>Annals of otology, rhinology &amp; laryngology</jtitle><addtitle>Ann Otol Rhinol Laryngol</addtitle><date>2021-06</date><risdate>2021</risdate><volume>130</volume><issue>6</issue><spage>591</spage><epage>601</epage><pages>591-601</pages><issn>0003-4894</issn><eissn>1943-572X</eissn><abstract>Objectives: To determine the impact of lymph node yield (LNY) in patients undergoing neck dissection at the time of total laryngectomy (TL). 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source Sage Journals Online
subjects Adult
Aged
Aged, 80 and over
Disease-Free Survival
Female
Humans
Laryngeal Neoplasms - mortality
Laryngeal Neoplasms - radiotherapy
Laryngeal Neoplasms - surgery
Laryngectomy
Lymph Node Ratio
Lymphatic Metastasis
Male
Margins of Excision
Middle Aged
Neck Dissection
Neoadjuvant Therapy
Radiotherapy, Adjuvant
Retrospective Studies
Salvage Therapy
title Impact of Lymph Node Yield in Patients Undergoing Total Laryngectomy and Neck Dissection
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