Is there a role for selective neck dissection after chemoradiation for head and neck cancer?
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Dissecting surgical specimens from the upper aerodigestive tract is often difficult because of their complicated anatomy. The local environment dictates the routes of tumour spread and surgical margins at risk, and these features differ for various subsites within this part of the body. The examination of surgical specimens of the upper aerodigestive tract should disclose whether postoperative adjuvant treatment is needed and allow the evaluation of preoperatively performed diagnostic imaging. The aim of this article is to provide a concise guideline for the dissection of specimens from this part of the body.
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T-lymphocyte subpopulations were quantitated in lymph nodes that contained metastatic tumor--or no metastasis--from patients who had squamous cell carcinoma of the upper aerodigestive tract. In addition, the lymphocyte subpopulations in peripheral blood were quantitated. The content of prostaglandin E2 within each node that was evaluated was also determined. Lymph nodes containing metastatic tumor had significantly higher helper/suppressor ratio than lymph nodes that were not involved. Quantification of the T-lymphocyte subpopulations in peripheral blood did not indicate the presence of metastatic disease. Significantly more prostaglandin E2 was present in lymph nodes containing metastatic disease, in comparison to lymph nodes without metastatic disease. Thus, both the lymphocyte subpopulations and prostaglandin levels were found to differentiate lymph nodes with metastasis from those without.
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