Is total nodal yield in neck dissections influenced by the method of specimen presentation to the pathologist?

Abstract 

Excision of the lymphatic structures in the neck is an integral part of the management of many head and neck cancers. Some surgeons dissect the specimens intraoperatively and send the groups of lymph nodes to the histopathologists in separate pots; others provide only a complete en bloc lymphadenectomy and rely on the pathologist to identify the anatomical areas. We aimed to find out whether the method by which specimens are presented to the histopathologist influenced the total nodal yield in neck dissections.

Eighty-seven consecutive neck dissections were compared and information collated as to how the specimens were presented to the histopathologist. The mean total yield was 33 (range 15–57). There was no significant difference in total nodal yield between specimens presented to the pathologist either en bloc or in individual groups (p=0.4).

Although specimens of neck dissections divided intraoperatively and presenting in nodal groups to the histopathologist in separate pots most probably permits more accurate anatomical assessment, it does not influence the total yield.

Keywords: Neck dissection, Lymph nodes, Squamous cell carcinoma, Neoplasm metastasis