Prognostic value of the nodal yield in head and neck squamous cell carcinoma: A systematic review

Head Neck. 2019 Aug;41(8):2801-2810. doi: 10.1002/hed.25764. Epub 2019 Apr 10.


Objective: Literature analysis on the prognostic factor of the nodal yield (NY) in neck dissections (NDs), which in general surgical oncology is a strong prognosticator and quality-of-care marker.

Methods: We performed a systematic review of all PubMed and Embase publications until June 30, 2018 screening for data on NY as prognosticator and overall survival (OS) as outcome in patients with head and neck squamous cell carcinoma (HNSCC). Risk for bias was asserted by application of the Quality In Prognosis Studies tool.

Results: Of the 823 screened publications, 15 were included in this analysis. Five out of seven that compared NY ≥18 vs <18 as prognosticator, showed significantly improved survival if NY ≥18. Six studies used other cutoffs and three reported improved survival with each additionally harvested lymph node.

Conclusion: Increased NY in ND specimen for HNSCC, most commonly described as ≥18 lymph nodes, is associated with improved OS and could be used as a prognosticator and quality-of-care marker.

Keywords: carcinoma; head and neck cancer; lymph node excision; neck dissection; nodal yield; oral cancer; prognosis; squamous cell.

Publication types

  • Systematic Review

MeSH terms

  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Lymph Nodes / pathology*
  • Neck Dissection*
  • Neoplasm Staging
  • Prognosis
  • Squamous Cell Carcinoma of Head and Neck / mortality
  • Squamous Cell Carcinoma of Head and Neck / pathology*
  • Survival Analysis