An Above-Average Lymph Node Yield Removed During Curative Neck Dissection in Advanced Head and Neck Squamous Cell Carcinomas Improves Survival

Sep 30, 2026

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This retrospective study evaluates whether the lymph node yield of a curative neck dissection influences survival in advanced head and neck squamous cell carcinoma (HNSCC). Data from 234 patients treated at a German university hospital between 1997 and 2018 were analyzed, including patient characteristics, tumor-specific factors, and the extent of neck dissection. Multivariate Cox models and Kaplan–Meier analyses showed above-average yields correlate with improved survival, especially in bilateral, ipsilateral, and contralateral dissections, with contralateral dissection linked to better overall prognosis.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Abstract

Objectives

Methods

Results

Conclusions

1. Introduction

Article An Above-Average Lymph Node Yield Removed During Curative Neck Dissection in Advanced Head and Neck Squamous Cell Carcinomas Improves Survival Miray-Su Yılmaz Topçuo ˘glu 1, *, Thiemo Seidler 1, Patrick J. Schuler 1, Christel Herold-Mende 1,2, Rolf Warta 1,2 and Gerhard Dyckhoff 1 Academic Editors: Myung-Ju Ahn and René-Jean Bensadoun Received: 23 November 2025 Revised: 19 December 2025 Accepted: 22 December 2025 Published: 25 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty of Heidelberg, University Hospital Heidelberg, 69120 Heidelberg, Germany; [thiemo.seidler@icloud.com](thiemo.seidler@icloud.com) (T.S.); patrick.schuler@med.uni-heidelberg.de (P.J.S.); christel.herold-mende@med.uni-heidelberg.de (C.H.-M.); rolf.warta@med.uni-heidelberg.de (R.W.); gerhard.dyckhoff@med.uni-heidelberg.de (G.D.) 2 Division of Experimental Neurosurgery, Department of Neurosurgery, Medical Faculty of Heidelberg, University Hospital Heidelberg, 69120 Heidelberg, Germany * Correspondence: miray-su.yilmaztopcuoglu@med.uni-heidelberg.de; Tel.: +49-6221-566752; Fax: +49-6221-567335 Simple Summary For appropriate treatment, lymph nodes must be removed in advanced squamous cell cancers of the head and neck in a procedure called neck dissection. The surgeon’s aim is to minimise surgical risk while achieving the best possible outcome, so the question of how many lymph nodes should be resected in these cases to gain a long survival remains a topic of discussion. The patient data, surgery information, and outcome of a total of 234 patients with this type of cancer who were treated at a German university hospital between 1997 and 2018 were investigated. The study showed that a thorough neck dissection involving an above-average number of nodes can improve survival rates, especially when performed on the side opposite the primary tumour. Abstract Objectives: The lymph node yield of a curative neck dissection for advanced head and neck squamous cell carcinoma (HNSCC) is an important factor in improving patient outcomes. Achieving adequate resection while minimising surgical risk is important. This retrospective study investigated the role of the lymph node yield for the survival of patients with HNSCC. Methods: A total of 234 patients with advanced HNSCC who were treated ata German university hospital between 1997 and 2018 were analysed. The analysis included patient data, tumour-specific characteristics, and the extent of neck dissection performed. Statistical analysis was performed using multivariate Cox proportional hazards models, supplemented by Kaplan–Meier analyses. Results: The median age was 60.0 years (range: 30–85 years, interquartile range: 12.3 years) . The follow-up period covered up to 25 years. According to the Union for International Cancer Control, n = 64 patients had UICC-stage III, and 170 patients had UICC-stage IV. The above-average lymph node yield was superior to average, but especially to below-average lymph node yields in bilateral (2.9-fold), ipsilateral (2.6-fold), and contralateral (10.7-fold) neck dissection. In particular, contralateral neck dissection was found to correlate with a significantly better prognosis in terms of overall survival when a higher number of lymph nodes were removed. Conclusions: The study suggests that a thorough and careful neck dissection involving the removal of a greater number of lymph nodes and including the contralateral side could significantly improve the survival for patients with advanced HNSCC. Keywords: HNSCC; lymph node yield; neck dissection; outcome; survival 1. Introduction Head and neck cancers are the sixth most common type of tumours worldwide [1–4] and are currently showing a growing incidence in youn

FAQs

What question does the study address about advanced HNSCC?

It examines how the lymph node yield removed during a curative neck dissection relates to patient survival in advanced head and neck squamous cell carcinomas.

How was the patient data analyzed?

The study analyzed 234 patients treated between 1997 and 2018 and used multivariate Cox proportional hazards models with Kaplan–Meier analyses.

What were the main survival findings regarding lymph node yield?

Above-average lymph node yield was associated with superior survival compared with average and below-average yields, with particularly strong effects in contralateral neck dissection.

Sep 30, 2026

Uploaded by Ezra