Recurrences in the Soft Tissues of the Neck after Surgery or Radiotherapy plus Surgery on Regional Lymph Nodes in Patients Bearing Carcinomas of the Head and Neck

1983 ◽  
Vol 69 (3) ◽  
pp. 255-259 ◽  
Author(s):  
Sante Basso-Ricci ◽  
Roberto Molinari ◽  
Gian Franco Brambilla
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Soft Tissues ◽  
Postoperative Radiotherapy ◽  
Cervical Region ◽  
Preoperative Radiation ◽  
Node Dissection ◽  
Regional Lymph Nodes ◽  
Node Metastases

A series of 45 recurrences in the soft tissues of the neck following lymph node dissection in 497 patients bearing carcinoma of the upper aerodigestive passages is reported. Only 22 cases that presented perilymph node metastases and/or in which there were reasons to indicate insufficient surgical radicality had been subjected to radiotherapy after surgical lymph node dissection; the other 23 cases had not been subjected to radiotherapy because the aforementioned premises had been lacking. All the recurrences therefore occurred in patients with clinically and histologically ascertained metastatic lymph nodes. The presence of perilymph node metastases and the judgement of surgical radicality was thus found insufficient criteria to plan future complementary postoperative radiotherapy. However, even in those cases in which postoperative radiotherapy was performed, there was a rather high incidence of recurrences, as high as 64.7% in patients with carcinoma of the tongue. Our data indicate the opportunity of a clinical trial with preoperative radiation therapy in patients with clinically evident lymph node metastases. Thirty-six of these recurrences were situated in the upper parts of the cervical region. The prognosis is very poor in such cases, so much so that only 2 of our series were disease free at 3 years after the treatment.

Surgical or Radiosurgical Failures on Cervical Lymph Nodes in Treatment of Head and Neck Cancer

1984 ◽  
Vol 70 (3) ◽  
pp. 261-266
Author(s):  
Sante Basso-Ricci ◽  
Gianfranco Coopmans de Yoldi ◽  
Luca de Flaviis ◽  
Franco Milani ◽  
Gian Maria Danesini
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Lymph Node Dissection ◽  
Radiation Treatment ◽  
Postoperative Radiotherapy ◽  
Head And Neck Carcinoma ◽  
Preoperative Radiation ◽  
Node Dissection ◽  
Cervical Lymph Nodes

From a series of 850 patients with head and neck carcinoma and subjected to lymph node dissection, 80 cases of recurrences in the neck have been collected. Postoperative radiotherapy was performed only in cases with metastatic extranodal spread. Of these recurrences, 56 occurred in the area of lymph node dissection, 7 were marginal and 17 were contralateral. The recurrences occurred prevalently in node-positive (N +) patients (70 of 80). The incidence of recurrences in the dissection area was 41.6 % (25 of 60) in cases with metastatic extranodal spread, despite postoperative radiotherapy. The incidence of recurrences in cases with clinically evident metastases at the time of dissection but without extranodal spread and not subjected to postoperative radiotherapy was relatively high (24.1 %, or 28 of 116). Since recurrences occurred, despite postoperative radiotherapy, in a relatively high percentage of cases with carcinoma of the oral floor and of the tongue (59.1 % and 50 %, respectively), it seems justifiable to perform preoperative radiation treatment in cases with clinically evident metastatic lymph nodes. As regards marginal recurrences, which all occurred in patients with carcinoma of the oral floor, it is considered sufficient to extend the surgical treatment to the subhyoid region. The high incidence of contralateral recurrences, which occurred mainly in patients with carcinoma of the larynx (13 of 17), shows the usefulness of radiation treatment of the contralateral region of the neck in these tumors, when dissection is limited to only one side of the neck.

scholarly journals D3 LYMPHADENECTOMY IN RIGHT COLONIC RESECTION

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 109-113
Author(s):  
Arshad Ahmed Baba ◽  
Zahid Kaleem ◽  
Fazl Qadir Parray ◽  
Nisar Ahmad Chowdri ◽  
Rouf Ahmad Wani ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
D3 Lymphadenectomy ◽  
Quality Of Surgery ◽  
Staining Techniques ◽  
Node Metastases ◽  
The Individual

Lymph node dissection in colon cancer is without a doubt necessary, it is just the extent of that dissection that is still under debate. As the individual steps of an oncologic operation cannot be separated from each other, analysis of the significance of lymph node dissection alone is difficult. It has been proven that the T category is directly related to the number and central spread of lymph node metastases. Micrometastases and isolated tumor cells may be detected in lymph nodes by using special staining techniques; their presence may worsen prognosis significantly and approximate it to UICC stage III. The numbers of dissected lymph nodes and the ratio of involved versus dissected lymph nodes have been used as markers for quality of surgery and histopathological evaluation. JMS 2018: 21 (2):109-113

scholarly journals Lymph Nodes Involvement and Lymphadenectomy in Thymic Tumors: Tentative Answers for Unsolved Questions

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5085
Author(s):  
Debora Brascia ◽  
Angela De De Palma ◽  
Marcella Schiavone ◽  
Giulia De De Iaco ◽  
Francesca Signore ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Lymph Node Metastases ◽  
Lymph Node Involvement ◽  
Postoperative Management ◽  
Anterior Mediastinum ◽  
Node Dissection ◽  
Node Metastases ◽  
Thymic Tumors

Thymic tumors are the most common primary neoplasms of the anterior mediastinum, although, when compared with the entire thoracic malignancies, they are still rare. Few studies addressed the questions about lymph node involvement pattern in thymic neoplasms, about which subgroup of patients would be appropriate candidates for lymph node dissection or about the extent of lymphadenectomy or which lymph nodes should be harvested. The aim of this review is to collect evidence from the literature to help physicians in designing the best surgical procedure when dealing with thymic malignancies. A literature review was performed through PubMed and Scopus in May 2021 to identify any study published in the last 20 years evaluating the frequency and the extent of lymph node dissection for thymic tumors, its impact on prognosis and on postoperative management. Fifteen studies met the inclusion criteria and were included in this review, with a total of 9452 patients with thymic cancers; lymph node metastases were found in 976 (10.3%) patients in total. The current literature is heterogeneous in the classification and reporting of lymph node metastases in thymic carcinoma, and data are hardly comparable. Surgical treatment should be guided by the few literature-based pieces of evidence and by the experience of the physicians.

Diagnostic accuracy of PET scan in salvage lymph node resections in patients with prostate cancer (CaP).

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 215-215
Author(s):  
David J. K. P. Pfister ◽  
Charlotte Piper ◽  
Daniel Porres ◽  
Theodor Klotz ◽  
Axel Heidenreich
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Diagnostic Accuracy ◽  
Lymph Node Dissection ◽  
Recurrent Disease ◽  
Node Dissection ◽  
Pet Ct ◽  
Salvage Lymph Node Dissection ◽  
Node Metastases

215 Background: PET-CT scans in patients with CaP are often used to identify either local recurrent disease or suspected lymph node metastases in early biochemical recurrent disease. The diagnostic accuracy is controversial. We want to show our experience of PET-CT and its diagnostic accuracy in salvage lymph node dissection. Methods: 21 patients treated with radical prostatectomy between 1997 and 2009 presented with PET-CT´s and biochemical recurrent disease and were treated by salvage lymph node dissection to prolong the time to either androgene deprivation or chemotherapy. Diagnostic accuracy was correlated per patient and per lymph nodes. Results: Mean PSA at time of lymph node dissection was 2,73 (0,4-8,4)ng/ml. 17 (81%) received prior radiotherapy and 6 (29%) received androgene deprivation. In total 203 lymph nodes were resected with 58 (29%) harbouring metastasis in 15 (71%) patients. This leads to a Sensitivity, Specifity, positive and negative predictive value of 69%, 12%, 76% and 88% concerning lymph node detection and 70%, 0%, 93% and 0% concerning the calculation per patient. At time of analysis follow-up was available in 5 patients with a biochemical recurrence free survival of 5 (3-12) months. Conclusions: The value of PET-CT in salvage lymph node dissection is under debate and must be questioned according to our results in this setting.

Utility of Gallium-67 in Determining the Radicality of Lymph Node Dissections of the Neck for Metastatic Lymph Nodes with Extranodal Spread in Patients Affected by Carcinoma of the Head and Neck

2000 ◽  
Vol 86 (4) ◽  
pp. 273-276
Author(s):  
Sante Basso Ricci ◽  
Arturo Chiti ◽  
Roberto Molinari ◽  
Giuseppe Borsa ◽  
Paolo Basso Ricci ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Soft Tissues ◽  
Postoperative Radiotherapy ◽  
Control Group ◽  
False Negatives ◽  
Node Metastases ◽  
Gallium 67

Aims and background Based on the fact that scintigraphy more readily reveals uptake of a radioisotope in a superficial position owing to incomplete surgical radicality, the authors examined by 67Ga scintigraphy a group of patients who had undergone dissection of lymph nodes of the neck from carcinoma with extranodal spread. They then checked the follow-up to ascertain the efficacy of 67Ga scintigraphy in relation to the eventual recurrences in the soft tissues of the neck. Methods A group of 136 patients were examined by 67Ga scintigraphy and followed for a minimum of 3 years after complementary radiotherapy. A group of 20 patients with no lymph node metastases was used as control to evaluate eventual false positives or false negatives. Results Recurrences in the soft tissues of the neck occurred in 35 (42.7%) of the 82 patients positive at 67Ga scintigraphy and in 6 (11.1%) of the 54 patients negative at the examination (P = 0.0001). All the patients in the control group were negative at 67Ga scintigraphy and without recurrences. Conclusions 67Ga scintigraphy can give reliable information on the risk of recurrences in the soft tissues of the neck. Since in spite of postoperative radiotherapy the percentage of local recurrences in cases with positive 67Ga scintigraphy was rather high (42.7%), the authors propose a scheme of radiotherapy based on administration of a higher dose per fraction on the scintigraphically positive area.

Role of lymph node dissection for intrahepatic cholangiocarcinoma.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 457-457
Author(s):  
Taizo Hibi ◽  
Yusuke Takemura ◽  
Osamu Itano ◽  
Masahiro Shinoda ◽  
Minoru Kitago ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Lymph Node Metastases ◽  
Node Dissection ◽  
Dominant Type ◽  
R1 Resection ◽  
Node Metastases

457 Background: The prognosis of intrahepatic cholangiocarcinoma (ICC) with lymph node metastases is dismal. Recent studies have highlighted the importance of lymph node retrieval from disease staging and therapeutic standpoints. To define the role of lymph node dissection for ICC, this study aimed to evaluate the patterns of lymph node metastases and their prognostic implication. Methods: A retrospective cohort analysis was conducted for 56 consecutive patients who underwent R0/R1 resection for ICC between 1990 and 2015. In principle, lymph nodes in the hepatic hilum and around the pancreas head were systematically removed. For left-sided tumors, lymph nodes in the lesser curvature of the stomach and the root of left gastric artery were also dissected. Clinicopathologic predictors of 3-year survival were identified by Cox multivariate analyses. Lymph node mapping was performed and positive nodes were classified into 3 compartments based on metastatic rates and prognoses. Results: Median tumor size, 4.5 (1.5–16.0) cm; Mass-forming and its dominant type, 42 (75%); R0 resection, 47 (84%). Nineteen (34%) patients had lymph node metastases. After excluding 4 in-hospital deaths, the overall and recurrence-free survival rates at 3 years were 66% and 33%, respectively (median follow-up, 36 months). Cox multivariate analysis revealed lymph node metastases [hazard ratio (HR) 6.3, 95% confidence interval (CI) 1.9-21.7, P = 0.003] and R1 resection (HR 7.8, 95% CI 1.6-38.3, P = 0.01) as independent negative predictors of overall survival. Patients with ≥ 4 positive nodes ( n = 7) had significantly decreased survival compared with those with 1–3 positive nodes ( n = 10, P= 0.005). Metastatic lymph nodes were classified into compartments I (metastatic rates ≥ 10% and longest survival ≥ 3 years), II (5%–10% and 1-year survival ≥ 50%), and III ( < 5% and 1-year survival < 50%). Lymph nodes in the suprapyloric area, celiac trunk, and paraaorta belonged to compartment III and appeared less important to be dissected. Conclusions: Systematic lymph node dissection for ICC based on tumor location provides accurate staging and may prolong survival in patients with limited number of positive nodes. Compartment classification is useful to determine the extent of dissection.

The role of elective lymph node dissection in melanoma: rationale, results, and controversies.

1988 ◽  
Vol 6 (1) ◽  
pp. 163-172 ◽  
Author(s):  
C M Balch
Keyword(s):  
Clinical Trials ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Anatomic Site ◽  
Regional Lymph Nodes ◽  
Surgical Trials ◽  
Elective Lymph Node Dissection ◽  
Large Patient

Elective lymph node dissection (ELND) for patients with clinically occult metastatic melanoma in regional lymph nodes has the goal of curing metastases with a surgical treatment. This is in contrast to the low probability for surgical cure in patients with clinically detectable lymph node metastases. The rationale for elective node dissection is based on a hypothesis that melanoma metastasizes sequentially via lymph nodes and then to distant sites. A subgroup of melanoma patients with high risk for regional node micrometastases but low risk for distant micrometastases has been identified from prognostic factors analysis of large patient series, as well as surgical results of nonrandomized clinical trials. However, two nonrandomized surgical trials have failed to show a survival benefit for ELND. These studies were largely performed in female patients with extremity melanomas and there were limitations that preclude a definitive conclusion. No randomized trials have been conducted involving melanomas of the trunk or head and neck. Two prospective randomized surgical trials are now being conducted in North America and in Europe. Until the results of these trials are available, physicians are encouraged to enter patients into these ongoing clinical trials or consider ELND in selected patients where the benefit-risk ratio justifies it. Factors to be considered in this decision include intermediate tumor thickness (ie, 1 to 4 mm thickness), anatomic site, histology (ulceration and growth pattern), and the risk of the operation in individual patient settings.

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