Review of oncological findings and complications after elective neck dissection during total laryngectomy: a case series

Abstract Background This study aims to report the rate of occult lymph node metastasis during elective neck dissection in clinically and radiologically negative neck (cN0) for patients offered total laryngectomy as either primary or salvage treatment. We also compare the rate of complications and re...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Mahmoud Elsayed, Nada Dwiddar, Amr Allam, Kishan Ubayasiri, Anthony Simons, Neeraj Sethi
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Laryngectomy (salvage/primary) Head and neck cancer Squamous cell carcinoma Neck dissection Occult lymph node metastasis Otorhinolaryngology RF1-547
Acceso en línea:	https://doaj.org/article/2eaefd2b7b994c3cba10793eeac1ce70
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2eaefd2b7b994c3cba10793eeac1ce70
record_format	dspace
spelling	oai:doaj.org-article:2eaefd2b7b994c3cba10793eeac1ce702021-11-07T12:06:50ZReview of oncological findings and complications after elective neck dissection during total laryngectomy: a case series10.1186/s43163-021-00177-81012-55742090-8539https://doaj.org/article/2eaefd2b7b994c3cba10793eeac1ce702021-11-01T00:00:00Zhttps://doi.org/10.1186/s43163-021-00177-8https://doaj.org/toc/1012-5574https://doaj.org/toc/2090-8539Abstract Background This study aims to report the rate of occult lymph node metastasis during elective neck dissection in clinically and radiologically negative neck (cN0) for patients offered total laryngectomy as either primary or salvage treatment. We also compare the rate of complications and recurrence after elective neck dissection during total laryngectomy. A retrospective review of patients treated in a single teaching hospital in the UK between 2004 and 2020 was performed. We collected the following patient information: age, sex, TNM staging, tumour location and laterality, primary treatment received if recurrent, preoperative imaging, operative details of the elective neck dissection, pathology results, postoperative complications, and recurrence. Inclusion criteria are as follows: squamous cell carcinoma and cN0 neck. Exclusion criteria are as follows: second primary tumour in the head and neck, a total laryngectomy because of a dysfunctional larynx, or a previously performed neck dissection. Results Of the 105 included patients, 66 (63%) had primary surgery and 39 (37%) were offered salvage surgery. All cases in the primary group were offered elective neck dissection. Thirty-six patients of the salvage group were offered elective neck dissection. The rate of occult lymph node metastasis was 35% (23/66) and 5.6% (2/36) in the primary and salvage groups, respectively. There was no difference in the overall complication rate in both groups, although the specific incidence of pharyngocutaneous fistula in the salvage group was higher compared with the primary group, 14% vs 7.5%. Conclusions We conclude that elective neck dissection is indicated during primary total laryngectomy due to the high rate of occult lymph node metastasis, 35% (23/66) in our series. Conversely, from our data in the salvage setting, the rate of occult lymph node was very low at 5.6% (2/36). The impact on survival is not known. The decision over elective neck dissection may be made more judiciously on an individual basis in the salvage setting.Mahmoud ElsayedNada DwiddarAmr AllamKishan UbayasiriAnthony SimonsNeeraj SethiSpringerOpenarticleLaryngectomy (salvage/primary)Head and neck cancerSquamous cell carcinomaNeck dissectionOccult lymph node metastasisOtorhinolaryngologyRF1-547ENThe Egyptian Journal of Otolaryngology, Vol 37, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Laryngectomy (salvage/primary) Head and neck cancer Squamous cell carcinoma Neck dissection Occult lymph node metastasis Otorhinolaryngology RF1-547
spellingShingle	Laryngectomy (salvage/primary) Head and neck cancer Squamous cell carcinoma Neck dissection Occult lymph node metastasis Otorhinolaryngology RF1-547 Mahmoud Elsayed Nada Dwiddar Amr Allam Kishan Ubayasiri Anthony Simons Neeraj Sethi Review of oncological findings and complications after elective neck dissection during total laryngectomy: a case series
description	Abstract Background This study aims to report the rate of occult lymph node metastasis during elective neck dissection in clinically and radiologically negative neck (cN0) for patients offered total laryngectomy as either primary or salvage treatment. We also compare the rate of complications and recurrence after elective neck dissection during total laryngectomy. A retrospective review of patients treated in a single teaching hospital in the UK between 2004 and 2020 was performed. We collected the following patient information: age, sex, TNM staging, tumour location and laterality, primary treatment received if recurrent, preoperative imaging, operative details of the elective neck dissection, pathology results, postoperative complications, and recurrence. Inclusion criteria are as follows: squamous cell carcinoma and cN0 neck. Exclusion criteria are as follows: second primary tumour in the head and neck, a total laryngectomy because of a dysfunctional larynx, or a previously performed neck dissection. Results Of the 105 included patients, 66 (63%) had primary surgery and 39 (37%) were offered salvage surgery. All cases in the primary group were offered elective neck dissection. Thirty-six patients of the salvage group were offered elective neck dissection. The rate of occult lymph node metastasis was 35% (23/66) and 5.6% (2/36) in the primary and salvage groups, respectively. There was no difference in the overall complication rate in both groups, although the specific incidence of pharyngocutaneous fistula in the salvage group was higher compared with the primary group, 14% vs 7.5%. Conclusions We conclude that elective neck dissection is indicated during primary total laryngectomy due to the high rate of occult lymph node metastasis, 35% (23/66) in our series. Conversely, from our data in the salvage setting, the rate of occult lymph node was very low at 5.6% (2/36). The impact on survival is not known. The decision over elective neck dissection may be made more judiciously on an individual basis in the salvage setting.
format	article
author	Mahmoud Elsayed Nada Dwiddar Amr Allam Kishan Ubayasiri Anthony Simons Neeraj Sethi
author_facet	Mahmoud Elsayed Nada Dwiddar Amr Allam Kishan Ubayasiri Anthony Simons Neeraj Sethi
author_sort	Mahmoud Elsayed
title	Review of oncological findings and complications after elective neck dissection during total laryngectomy: a case series
title_short	Review of oncological findings and complications after elective neck dissection during total laryngectomy: a case series
title_full	Review of oncological findings and complications after elective neck dissection during total laryngectomy: a case series
title_fullStr	Review of oncological findings and complications after elective neck dissection during total laryngectomy: a case series
title_full_unstemmed	Review of oncological findings and complications after elective neck dissection during total laryngectomy: a case series
title_sort	review of oncological findings and complications after elective neck dissection during total laryngectomy: a case series
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/2eaefd2b7b994c3cba10793eeac1ce70
work_keys_str_mv	AT mahmoudelsayed reviewofoncologicalfindingsandcomplicationsafterelectiveneckdissectionduringtotallaryngectomyacaseseries AT nadadwiddar reviewofoncologicalfindingsandcomplicationsafterelectiveneckdissectionduringtotallaryngectomyacaseseries AT amrallam reviewofoncologicalfindingsandcomplicationsafterelectiveneckdissectionduringtotallaryngectomyacaseseries AT kishanubayasiri reviewofoncologicalfindingsandcomplicationsafterelectiveneckdissectionduringtotallaryngectomyacaseseries AT anthonysimons reviewofoncologicalfindingsandcomplicationsafterelectiveneckdissectionduringtotallaryngectomyacaseseries AT neerajsethi reviewofoncologicalfindingsandcomplicationsafterelectiveneckdissectionduringtotallaryngectomyacaseseries
_version_	1718443537873240064

Review of oncological findings and complications after elective neck dissection during total laryngectomy: a case series

Ejemplares similares