Evidence map›Paper›PMID 41175182›Full record

ArticleAnnals of surgical oncology2026

Facial Vein Ligation is Associated with Lymphedema Among Patients with Head and Neck Cancer Undergoing Surgery and Radiation.

Richard A Raad, Fendi Obuekwe, Joshua D Smith, Jacklyn Berry, Steven B Chinn, Bradley E Spector, Jessica Maxwell, Seungwon Kim, Jose P Zevallos, Kevin J Contrera and 3 more

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07694726 (Lymphedema Prevention With Facial Vein Preservation or Reconstruction During Neck Dissection for Operable Head & Neck Cancer), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07694726 nanot yet recruitingnot on this map

Lymphedema Prevention With Facial Vein Preservation or Reconstruction During Neck Dissection for Operable Head & Neck Cancer

TypeinterventionalSponsorUniversity of PittsburghRan2026 to 2028Enrolled37ConditionsHead and Neck CancerArmsFacial Vein Reconstruction
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Richard A RaadDepartment of Otolaryngology Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Fendi ObuekweSchool of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Joshua D SmithDepartment of Otolaryngology Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Jacklyn BerryUniversity of Pittsburgh Medical Center Rehabilitation Institute, Pittsburgh, PA, USA.
Steven B ChinnDepartment of Otolaryngology Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Bradley E SpectorDepartment of Otolaryngology Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Jessica MaxwellDepartment of Otolaryngology Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Seungwon KimDepartment of Otolaryngology Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Jose P ZevallosDepartment of Otolaryngology Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Kevin J ContreraDepartment of Otolaryngology Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Shaum S SridharanDepartment of Otolaryngology Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Marci Lee NilsenDepartment of Otolaryngology Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Matthew E SpectorDepartment of Otolaryngology Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. mspector81@gmail.com.

Funding

NIDCR NIH HHS 1R37CA279210-01A1
6 · The paper itself

Abstract

backgroundHead and neck lymphedema (HNL) is common after head and neck cancer (HNC) treatments. For unclear reasons, it is more likely to develop after lymphadenectomy and radiation than after either alone. Therefore, we investigated associations between facial vein ligation and HNL among patients who underwent lymphadenectomy and radiation.

methodsThis was a retrospective cohort study of treatment-naïve patients who underwent cervical lymphadenectomy and completed adjuvant radiation at a single, tertiary center. Preoperative and 1-year postoperative computed tomography scans were reviewed to assess the patency of the facial veins in each neck. The presence of lymphedema was determined clinically by a lymphedema therapist 1 year after treatment and classified according to the MD Anderson Cancer Center Lymphedema Rating Scale.

resultsIn total, 84 patients were included, 44 had lymphedema 1 year after treatment. At least one facial vein was ligated in 88.6% of those with lymphedema and in 57.5% of those without lymphedema (p < 0.001). Those with lymphedema had fewer patent facial veins than those without lymphedema (mean 0.81 vs. 1.23, p = 0.009) and ligation of at least one facial vein was associated with an odds ratio for lymphedema of 5.77 (95% confidence interval 1.88-17.71; p < 0.001). Multivariable logistic regression analysis confirmed a significant difference in lymphedema among those with at least one facial vein ligated (odds ratio 8.87; 95% confidence interval 2.46-31.99; p < 0.001).

conclusionFacial vein ligation is associated with lymphedema among patients with HNC who undergo lymphadenectomy and radiation. This suggests that veins may help the body compensate for the disruption of cervicofacial lymphatics that occur as a result of these treatments.

Indexed as

FaceHead and Neck NeoplasmsLymphedemaLymph Node ExcisionNeck DissectionVeinsAdultAgedFemaleFollow-Up StudiesHumansLigationMaleMiddle AgedPrognosisRadiotherapy, AdjuvantHead and neck cancerLymphedemaQuality of lifeVein ligation

Identifiers

PMID41175182

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