Impact of Radiotherapy on Neck Dissection Nodal Count in Patients With Head and Neck Cancer
Objectives/Hypothesis Our study aimed to review the impact of preoperative radiotherapy (RT) and other factors on the lymph node count of neck dissection (ND) specimens from patients with head and neck cancer (HNC). A retrospective study was conducted on all patients with head and neck cancers who h...
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| Veröffentlicht in: | The Laryngoscope 2020-08, Vol.130 (8), p.1947-1953 |
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| container_end_page | 1953 |
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| container_issue | 8 |
| container_start_page | 1947 |
| container_title | The Laryngoscope |
| container_volume | 130 |
| creator | Yu, Yue Sultana, Rehena Rangabashyam, Mahalakshmi S. Mohan, Niraj Hwang, Jacqueline S. G. Soong, Yoke‐Lim Tan, Ngian‐Chye Iyer, Gopalakrishna N. Tan, Hiang‐Khoon |
| description | Objectives/Hypothesis
Our study aimed to review the impact of preoperative radiotherapy (RT) and other factors on the lymph node count of neck dissection (ND) specimens from patients with head and neck cancer (HNC). A retrospective study was conducted on all patients with head and neck cancers who had undergone NDs in Singapore General Hospital between 1992 and 2013.
Study Design
Retrospective study.
Methods
Patients were categorized into two groups: patients treated with RT with or without chemotherapy before ND and patients who had undergone ND surgery without previous history of RT. The primary endpoint for this study would be the lymph node count from ND.
Results
The study cohort consists of 1,024 NDs on 829 patients. There were 597 (58.3%) radical/modified radical NDs involving levels I–V. Within this group, 75 (12.6%) NDs had preoperative RT. Preoperative RT and age were found to significantly reduce nodal yield in both univariate and multivariate analysis in the radical/modified radical ND subgroup. In our multivariate analysis, preoperative RT was shown to decrease the nodal yield by 7.464 (P = .0002, 95% confidence interval [CI]: −11.35 to −3.58). Advanced age independently decreases nodal yield, even after accounting for the effect of RT (P = .0002, 95% CI: −0.27 to −0.08). In addition, preoperative RT has a more pronounced effect in reducing lymph node count in the older age group.
Conclusions
Preoperative RT and advanced age are independent and synergistic factors that reduce nodal count from NDs in patients with head and neck cancers.
Level of Evidence
4 Laryngoscope, 130: 1947–1953, 2020 |
| doi_str_mv | 10.1002/lary.28620 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2402440416</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2423035055</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3570-a4f4f3524c7b9a535ac93eac0fd1d7065d1708f3b429804519baab9e792f9e0c3</originalsourceid><addsrcrecordid>eNp9kE1LxDAQhoMoun5c_AES8CJCdfK13Rxl_VhhURFFxUOZpilGu83atMj-e7NWPXjwNAzzzMvMQ8gugyMGwI8rbBZHfDTksEIGTAmWSK3VKhnEoUhGij9ukM0QXgFYKhSskw3BJTChhwPyfDmbo2mpL-ktFs63L7bB-YL6ml5Z80ZPXQjWtG7Z-wIrOvZd3VJX0xtsna3bQB9c-0InFguKddFvjbE2ttkmayVWwe581y1yf352N54k0-uLy_HJNDFCpZCgLGUpFJcmzTUqodBoYdFAWbAihaEqWAqjUuSS6xFIxXSOmGubal5qC0ZskYM-d974986GNpu5YGxVYW19F7L4LJcSJBtGdP8P-uq7po7XRYoLiHqUitRhT5nGh9DYMps3bhYtZwyypfJsqTz7Uh7hve_ILp_Z4hf9cRwB1gMfrrKLf6Ky6cntUx_6CR3jif4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2423035055</pqid></control><display><type>article</type><title>Impact of Radiotherapy on Neck Dissection Nodal Count in Patients With Head and Neck Cancer</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Yu, Yue ; Sultana, Rehena ; Rangabashyam, Mahalakshmi S. ; Mohan, Niraj ; Hwang, Jacqueline S. G. ; Soong, Yoke‐Lim ; Tan, Ngian‐Chye ; Iyer, Gopalakrishna N. ; Tan, Hiang‐Khoon</creator><creatorcontrib>Yu, Yue ; Sultana, Rehena ; Rangabashyam, Mahalakshmi S. ; Mohan, Niraj ; Hwang, Jacqueline S. G. ; Soong, Yoke‐Lim ; Tan, Ngian‐Chye ; Iyer, Gopalakrishna N. ; Tan, Hiang‐Khoon</creatorcontrib><description>Objectives/Hypothesis
Our study aimed to review the impact of preoperative radiotherapy (RT) and other factors on the lymph node count of neck dissection (ND) specimens from patients with head and neck cancer (HNC). A retrospective study was conducted on all patients with head and neck cancers who had undergone NDs in Singapore General Hospital between 1992 and 2013.
Study Design
Retrospective study.
Methods
Patients were categorized into two groups: patients treated with RT with or without chemotherapy before ND and patients who had undergone ND surgery without previous history of RT. The primary endpoint for this study would be the lymph node count from ND.
Results
The study cohort consists of 1,024 NDs on 829 patients. There were 597 (58.3%) radical/modified radical NDs involving levels I–V. Within this group, 75 (12.6%) NDs had preoperative RT. Preoperative RT and age were found to significantly reduce nodal yield in both univariate and multivariate analysis in the radical/modified radical ND subgroup. In our multivariate analysis, preoperative RT was shown to decrease the nodal yield by 7.464 (P = .0002, 95% confidence interval [CI]: −11.35 to −3.58). Advanced age independently decreases nodal yield, even after accounting for the effect of RT (P = .0002, 95% CI: −0.27 to −0.08). In addition, preoperative RT has a more pronounced effect in reducing lymph node count in the older age group.
Conclusions
Preoperative RT and advanced age are independent and synergistic factors that reduce nodal count from NDs in patients with head and neck cancers.
Level of Evidence
4 Laryngoscope, 130: 1947–1953, 2020</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.28620</identifier><identifier>PMID: 32401396</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Age ; Head & neck cancer ; head and neck neoplasm ; lymph node count ; lymphadenectomy ; Lymphatic system ; Multivariate analysis ; preoperative radiotherapy, radiation therapy ; Radiation therapy</subject><ispartof>The Laryngoscope, 2020-08, Vol.130 (8), p.1947-1953</ispartof><rights>2020 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3570-a4f4f3524c7b9a535ac93eac0fd1d7065d1708f3b429804519baab9e792f9e0c3</citedby><cites>FETCH-LOGICAL-c3570-a4f4f3524c7b9a535ac93eac0fd1d7065d1708f3b429804519baab9e792f9e0c3</cites><orcidid>0000-0003-4172-2109 ; 0000-0002-8784-2678 ; 0000-0002-8812-6219</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.28620$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.28620$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32401396$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yu, Yue</creatorcontrib><creatorcontrib>Sultana, Rehena</creatorcontrib><creatorcontrib>Rangabashyam, Mahalakshmi S.</creatorcontrib><creatorcontrib>Mohan, Niraj</creatorcontrib><creatorcontrib>Hwang, Jacqueline S. G.</creatorcontrib><creatorcontrib>Soong, Yoke‐Lim</creatorcontrib><creatorcontrib>Tan, Ngian‐Chye</creatorcontrib><creatorcontrib>Iyer, Gopalakrishna N.</creatorcontrib><creatorcontrib>Tan, Hiang‐Khoon</creatorcontrib><title>Impact of Radiotherapy on Neck Dissection Nodal Count in Patients With Head and Neck Cancer</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objectives/Hypothesis
Our study aimed to review the impact of preoperative radiotherapy (RT) and other factors on the lymph node count of neck dissection (ND) specimens from patients with head and neck cancer (HNC). A retrospective study was conducted on all patients with head and neck cancers who had undergone NDs in Singapore General Hospital between 1992 and 2013.
Study Design
Retrospective study.
Methods
Patients were categorized into two groups: patients treated with RT with or without chemotherapy before ND and patients who had undergone ND surgery without previous history of RT. The primary endpoint for this study would be the lymph node count from ND.
Results
The study cohort consists of 1,024 NDs on 829 patients. There were 597 (58.3%) radical/modified radical NDs involving levels I–V. Within this group, 75 (12.6%) NDs had preoperative RT. Preoperative RT and age were found to significantly reduce nodal yield in both univariate and multivariate analysis in the radical/modified radical ND subgroup. In our multivariate analysis, preoperative RT was shown to decrease the nodal yield by 7.464 (P = .0002, 95% confidence interval [CI]: −11.35 to −3.58). Advanced age independently decreases nodal yield, even after accounting for the effect of RT (P = .0002, 95% CI: −0.27 to −0.08). In addition, preoperative RT has a more pronounced effect in reducing lymph node count in the older age group.
Conclusions
Preoperative RT and advanced age are independent and synergistic factors that reduce nodal count from NDs in patients with head and neck cancers.
Level of Evidence
4 Laryngoscope, 130: 1947–1953, 2020</description><subject>Age</subject><subject>Head & neck cancer</subject><subject>head and neck neoplasm</subject><subject>lymph node count</subject><subject>lymphadenectomy</subject><subject>Lymphatic system</subject><subject>Multivariate analysis</subject><subject>preoperative radiotherapy, radiation therapy</subject><subject>Radiation therapy</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LxDAQhoMoun5c_AES8CJCdfK13Rxl_VhhURFFxUOZpilGu83atMj-e7NWPXjwNAzzzMvMQ8gugyMGwI8rbBZHfDTksEIGTAmWSK3VKhnEoUhGij9ukM0QXgFYKhSskw3BJTChhwPyfDmbo2mpL-ktFs63L7bB-YL6ml5Z80ZPXQjWtG7Z-wIrOvZd3VJX0xtsna3bQB9c-0InFguKddFvjbE2ttkmayVWwe581y1yf352N54k0-uLy_HJNDFCpZCgLGUpFJcmzTUqodBoYdFAWbAihaEqWAqjUuSS6xFIxXSOmGubal5qC0ZskYM-d974986GNpu5YGxVYW19F7L4LJcSJBtGdP8P-uq7po7XRYoLiHqUitRhT5nGh9DYMps3bhYtZwyypfJsqTz7Uh7hve_ILp_Z4hf9cRwB1gMfrrKLf6Ky6cntUx_6CR3jif4</recordid><startdate>202008</startdate><enddate>202008</enddate><creator>Yu, Yue</creator><creator>Sultana, Rehena</creator><creator>Rangabashyam, Mahalakshmi S.</creator><creator>Mohan, Niraj</creator><creator>Hwang, Jacqueline S. G.</creator><creator>Soong, Yoke‐Lim</creator><creator>Tan, Ngian‐Chye</creator><creator>Iyer, Gopalakrishna N.</creator><creator>Tan, Hiang‐Khoon</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4172-2109</orcidid><orcidid>https://orcid.org/0000-0002-8784-2678</orcidid><orcidid>https://orcid.org/0000-0002-8812-6219</orcidid></search><sort><creationdate>202008</creationdate><title>Impact of Radiotherapy on Neck Dissection Nodal Count in Patients With Head and Neck Cancer</title><author>Yu, Yue ; Sultana, Rehena ; Rangabashyam, Mahalakshmi S. ; Mohan, Niraj ; Hwang, Jacqueline S. G. ; Soong, Yoke‐Lim ; Tan, Ngian‐Chye ; Iyer, Gopalakrishna N. ; Tan, Hiang‐Khoon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3570-a4f4f3524c7b9a535ac93eac0fd1d7065d1708f3b429804519baab9e792f9e0c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Head & neck cancer</topic><topic>head and neck neoplasm</topic><topic>lymph node count</topic><topic>lymphadenectomy</topic><topic>Lymphatic system</topic><topic>Multivariate analysis</topic><topic>preoperative radiotherapy, radiation therapy</topic><topic>Radiation therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yu, Yue</creatorcontrib><creatorcontrib>Sultana, Rehena</creatorcontrib><creatorcontrib>Rangabashyam, Mahalakshmi S.</creatorcontrib><creatorcontrib>Mohan, Niraj</creatorcontrib><creatorcontrib>Hwang, Jacqueline S. G.</creatorcontrib><creatorcontrib>Soong, Yoke‐Lim</creatorcontrib><creatorcontrib>Tan, Ngian‐Chye</creatorcontrib><creatorcontrib>Iyer, Gopalakrishna N.</creatorcontrib><creatorcontrib>Tan, Hiang‐Khoon</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Yue</au><au>Sultana, Rehena</au><au>Rangabashyam, Mahalakshmi S.</au><au>Mohan, Niraj</au><au>Hwang, Jacqueline S. G.</au><au>Soong, Yoke‐Lim</au><au>Tan, Ngian‐Chye</au><au>Iyer, Gopalakrishna N.</au><au>Tan, Hiang‐Khoon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Radiotherapy on Neck Dissection Nodal Count in Patients With Head and Neck Cancer</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2020-08</date><risdate>2020</risdate><volume>130</volume><issue>8</issue><spage>1947</spage><epage>1953</epage><pages>1947-1953</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis
Our study aimed to review the impact of preoperative radiotherapy (RT) and other factors on the lymph node count of neck dissection (ND) specimens from patients with head and neck cancer (HNC). A retrospective study was conducted on all patients with head and neck cancers who had undergone NDs in Singapore General Hospital between 1992 and 2013.
Study Design
Retrospective study.
Methods
Patients were categorized into two groups: patients treated with RT with or without chemotherapy before ND and patients who had undergone ND surgery without previous history of RT. The primary endpoint for this study would be the lymph node count from ND.
Results
The study cohort consists of 1,024 NDs on 829 patients. There were 597 (58.3%) radical/modified radical NDs involving levels I–V. Within this group, 75 (12.6%) NDs had preoperative RT. Preoperative RT and age were found to significantly reduce nodal yield in both univariate and multivariate analysis in the radical/modified radical ND subgroup. In our multivariate analysis, preoperative RT was shown to decrease the nodal yield by 7.464 (P = .0002, 95% confidence interval [CI]: −11.35 to −3.58). Advanced age independently decreases nodal yield, even after accounting for the effect of RT (P = .0002, 95% CI: −0.27 to −0.08). In addition, preoperative RT has a more pronounced effect in reducing lymph node count in the older age group.
Conclusions
Preoperative RT and advanced age are independent and synergistic factors that reduce nodal count from NDs in patients with head and neck cancers.
Level of Evidence
4 Laryngoscope, 130: 1947–1953, 2020</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>32401396</pmid><doi>10.1002/lary.28620</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-4172-2109</orcidid><orcidid>https://orcid.org/0000-0002-8784-2678</orcidid><orcidid>https://orcid.org/0000-0002-8812-6219</orcidid></addata></record> |
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| ispartof | The Laryngoscope, 2020-08, Vol.130 (8), p.1947-1953 |
| issn | 0023-852X 1531-4995 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2402440416 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Age Head & neck cancer head and neck neoplasm lymph node count lymphadenectomy Lymphatic system Multivariate analysis preoperative radiotherapy, radiation therapy Radiation therapy |
| title | Impact of Radiotherapy on Neck Dissection Nodal Count in Patients With Head and Neck Cancer |
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