Clinical implication of neck dissection for metastatic lymph nodes originating from non-head and neck regions

Abstract

Background

Cervical lymph node metastasis (CLNM) from remote primary sites is rare in head and neck cancer. The efficacy of neck dissection is still being investigated for therapeutic benefits of local management in oligometastasis from non-head and neck cancer.

Objectives

To evaluate the clinical efficacy of neck dissection (ND) in CLNM from distant primary cancers and identify factors contributing to improved survival.

Materials and methods

This retrospective case-control study enrolled patients who underwent ND for CLNM from distant primary cancer at Asan Medical Centre between January 2010 and December 2020. We analysed overall survival and association between clinical covariate and survival.

Results

The study included 31 (14 males, 17 females) among 114 patients. Ovarian cancer was the most common primary malignancy (32.3%). Patients with fewer than three metastatic lymph nodes, without extranodal extension and with adjuvant therapy after surgery had better survival rates.

Conclusion and significance

In patients with CLNM from a distant primary cancer, ND is beneficial as local treatment. And adequate selection of patients for ND is pivotal to improve prognosis.

Chinese Abstract

背景：来自远处原发部位的颈部淋巴结转移 (CLNM) 在头部和颈部癌症中很少见。 颈清扫术的疗效仍在研究中, 以了解非头颈癌寡核苷酸转移的局部管理的治疗疗效。

目的：评估颈清扫术 (ND) 对远处原发性癌症CLNM 的临床疗效, 并确定有助于提高生存率的因素。

材料和方法：这项回顾性病例对照研究纳入了2010 年 1 月至 2020 年 12 月期间在牙山医疗中心接受 远处原发性癌症的 CLNM的ND 治疗的患者。我们分析了总体生存率以及临床协变量与生存率之间的相关性。

结果：该研究纳入了 114 名患者中的 31 名患者（14 名男性, 17 名女性）。 卵巢癌是

最常见的原发性恶性肿瘤（32.3%）。 转移淋巴结少于三个, 无结外扩展并接受术后辅助治疗的患者有更好的生存率。

结论和意义：对于来自远处原发癌的 CLNM 患者, 作为局部治疗的ND 是有益的。 适当选择接受ND的患者对于改善预后至关重要。

Keywords:

• Oligometastasis
• non-head and neck cancer
• neck dissection
• lymph node metastasis

Disclosure statement

The authors report there are no competing interests to declare.