Lymph Node Yield and Ratio during Surgery for Advanced Laryngeal Carcinoma

Abstract

Lymph node metastasis represents one of the most important prognostic factors in patients with head and neck squamous cell carcinomas (HNSCC). Lymph node yield (LNY) is the term used to indicate the total number of dissected lymph nodes following neck dissection, while lymph node ratio (LNR) is the proportion of metastatic lymph nodes to the total number of removed lymph nodes following neck dissection. This ratio serves to determine both the extent of cancer lymphatic spread and the effectiveness of its clearance. Calculating LNY and LNR following neck dissection holds particular significance when dealing with advanced laryngeal cancer. These values are supposed to have a direct impact on both prognosis and oncological outcomes, warranting their inclusion in the staging of such patients. Wide variations were observed in both LNY and LNR, which were mainly dependent not only on the tumor burden but also on surgical and pathological skills. Therefore, standardization is required in the pathological processing as well as surgical techniques of neck dissections to minimize these variations. Further studies are needed to validate these observations and to guide their inclusion in pathological TNM classification.