Primary Head and Neck Cancer

Histopathologic Predictors of Recurrence After Neck Dissection in Patients With Lymph Node Involvement

Kerry D. Olsen, Michela Caruso, Robert L. Foote, Robert J. Stanley, Jean E. Lewis, Steven J. Buskirk, Deborah Frassica, Lawrence W. Desanto, W. Michael O'fallon, Verna R. Hoverman

Research output: Contribution to journalArticle

Abstract

Objective: Retrospectively analyze several histopathologic variables that may predict neck recurrence after neck dissection. Design: From 1970 through 1980, 284 patients with pathologically confirmed metastatic squamous cell carcinoma underwent neck dissection and received no adjuvant therapy. Kaplan-Meier evaluation estimated a 74% 2-year neck recurrence–free rate. After adjusting for the standard covariates of age, gender, neck stage, and tumor grade, we also controlled for the time-dependent co-variates of primary recurrence, occurrence in the side of the neck not operated on, or development of new head and neck primary disease. Setting: A large referral-based practice. Results: The number of lymph nodes involved, invasion of vascular/lymphatic space, invasion of soft tissue, and desmoplastic lymph node pattern adversely affect neck recurrence. A desmoplastic stromal pattern was associated with almost a sevenfold increased risk of neck recurrence. To our knowledge, this finding has not been reported previously. Conclusion: Histopathologic evaluation of metastatically involved cervical nodes can identify patients with head and neck cancer who are at high risk for recurrence.

Original languageEnglish (US)
Pages (from-to)1370-1374
Number of pages5
JournalArchives of Otolaryngology--Head and Neck Surgery
Volume120
Issue number12
DOIs
StatePublished - 1994
Externally publishedYes

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Neck Dissection
Head and Neck Neoplasms
Neck
Lymph Nodes
Recurrence
Blood Vessels
Squamous Cell Carcinoma
Referral and Consultation
Head
Neoplasms

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

Primary Head and Neck Cancer : Histopathologic Predictors of Recurrence After Neck Dissection in Patients With Lymph Node Involvement. / Olsen, Kerry D.; Caruso, Michela; Foote, Robert L.; Stanley, Robert J.; Lewis, Jean E.; Buskirk, Steven J.; Frassica, Deborah; Desanto, Lawrence W.; O'fallon, W. Michael; Hoverman, Verna R.

In: Archives of Otolaryngology--Head and Neck Surgery, Vol. 120, No. 12, 1994, p. 1370-1374.

Research output: Contribution to journalArticle

Olsen, KD, Caruso, M, Foote, RL, Stanley, RJ, Lewis, JE, Buskirk, SJ, Frassica, D, Desanto, LW, O'fallon, WM & Hoverman, VR 1994, 'Primary Head and Neck Cancer: Histopathologic Predictors of Recurrence After Neck Dissection in Patients With Lymph Node Involvement', Archives of Otolaryngology--Head and Neck Surgery, vol. 120, no. 12, pp. 1370-1374. https://doi.org/10.1001/archotol.1994.01880360066012
Olsen, Kerry D. ; Caruso, Michela ; Foote, Robert L. ; Stanley, Robert J. ; Lewis, Jean E. ; Buskirk, Steven J. ; Frassica, Deborah ; Desanto, Lawrence W. ; O'fallon, W. Michael ; Hoverman, Verna R. / Primary Head and Neck Cancer : Histopathologic Predictors of Recurrence After Neck Dissection in Patients With Lymph Node Involvement. In: Archives of Otolaryngology--Head and Neck Surgery. 1994 ; Vol. 120, No. 12. pp. 1370-1374.
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abstract = "Objective: Retrospectively analyze several histopathologic variables that may predict neck recurrence after neck dissection. Design: From 1970 through 1980, 284 patients with pathologically confirmed metastatic squamous cell carcinoma underwent neck dissection and received no adjuvant therapy. Kaplan-Meier evaluation estimated a 74{\%} 2-year neck recurrence–free rate. After adjusting for the standard covariates of age, gender, neck stage, and tumor grade, we also controlled for the time-dependent co-variates of primary recurrence, occurrence in the side of the neck not operated on, or development of new head and neck primary disease. Setting: A large referral-based practice. Results: The number of lymph nodes involved, invasion of vascular/lymphatic space, invasion of soft tissue, and desmoplastic lymph node pattern adversely affect neck recurrence. A desmoplastic stromal pattern was associated with almost a sevenfold increased risk of neck recurrence. To our knowledge, this finding has not been reported previously. Conclusion: Histopathologic evaluation of metastatically involved cervical nodes can identify patients with head and neck cancer who are at high risk for recurrence.",
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AU - Stanley, Robert J.

AU - Lewis, Jean E.

AU - Buskirk, Steven J.

AU - Frassica, Deborah

AU - Desanto, Lawrence W.

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N2 - Objective: Retrospectively analyze several histopathologic variables that may predict neck recurrence after neck dissection. Design: From 1970 through 1980, 284 patients with pathologically confirmed metastatic squamous cell carcinoma underwent neck dissection and received no adjuvant therapy. Kaplan-Meier evaluation estimated a 74% 2-year neck recurrence–free rate. After adjusting for the standard covariates of age, gender, neck stage, and tumor grade, we also controlled for the time-dependent co-variates of primary recurrence, occurrence in the side of the neck not operated on, or development of new head and neck primary disease. Setting: A large referral-based practice. Results: The number of lymph nodes involved, invasion of vascular/lymphatic space, invasion of soft tissue, and desmoplastic lymph node pattern adversely affect neck recurrence. A desmoplastic stromal pattern was associated with almost a sevenfold increased risk of neck recurrence. To our knowledge, this finding has not been reported previously. Conclusion: Histopathologic evaluation of metastatically involved cervical nodes can identify patients with head and neck cancer who are at high risk for recurrence.

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