ArticleLaryngoscope investigative otolaryngology2025
Neck Dissection and Survival Among Head and Neck Cancer Patients Undergoing Adjuvant Immunotherapy.
Article in Laryngoscope investigative otolaryngology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Background: Some studies suggest that neck dissection (ND) should be avoided in candidates for immunotherapy because lymph nodes are primary sites for immunotherapy activation. Our study investigates ND utilization and associated differences in overall survival (OS) among patients with head and neck cancer (HNC) undergoing adjuvant immunotherapy. Methods: The 2013-2018 National Cancer Database was retrospectively reviewed for patients with HNC undergoing surgery with curative intent, and adjuvant immunotherapy. Multivariable binary logistic and Cox regression models adjusted for patient demographics, clinicopathologic features, and treatment. Results: Of 1335 patients satisfying inclusion criteria, 679 (50.9%) patients underwent ND: 94 (13.8%) had pN0, 109 (16.1%) had pN1, 411 (60.5%) had pN2, 60 (8.8%) had pN3, and 5 (0.7%) had pNx classification. On multivariable binary logistic regression, academic treatment facility, cT4, and cN1-3 classification were associated with higher odds of undergoing ND ( Conclusion: ND was utilized in approximately 51% of patients with HNC undergoing adjuvant immunotherapy. ND was not associated with worse OS, possibly related to the high rate of pN1-3 classification. Level of Evidence: 4.
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