(0713) Prognostic Value of Lymph Node Yield in Advanced Cutaneous Squamous Cell Carcinoma

Introduction: Previous studies have demonstrated lymph node metastasis as a prognostic factor in the development of disease. However, adequate consensus in the minimum lymph node yield (MNY) and positive lymph nodes ratios (LNR) have not been established. Our study aims to identify a MNY and LNR in patients with surgically treated HNCSCC to contribute novel evidence towards establishing quality standards. Secondarily, this study aims to determine the prognostic significance of MNY and LNR.

Methods: A retrospective chart review was conducted of patients with advanced HNCSCC surgically treated with curative intent at a single institution between January 1st, 2014 and December 1st, 2022. Patients with recurrent HNSCC or previous radiotherapy, immunotherapy, or chemotherapy of the primary tumor site were excluded. Charts were queried for demographics, comorbidities, surgical pathology, average nodal yield, and survival. Nodal yield was studied as a numerical variable for association with survival in univariate analyses.

Results: Among 30 patients included, 26 (87%) were male and 4, female. Of them, 15 patients had T1/T2 tumors, and 8 had T3/T4a tumors. Four patients could not be assessed. Of the total, 10 patients (34.48%) underwent a levels I-V dissection, and 10 patients underwent radical neck dissection. Three patients underwent a levels II-IV dissection, and one patient, levels I-III. Parotidectomies were underwent by 15 patients. The average lymph node yield was 31.6 (SD 16.39). A sum of 11 patients had positive lymph nodes with a mean of 2 positive nodes. Four patients died, two due to disease progression at a mean of 2.93 years. The OS at 7 years was 69.5% with a median DFS of 4.6 years. Each lymph node collected reduced the hazard of death by 4% (p = 0.2) and the hazard of recurrent disease by 2% (p = 0.13).

Conclusions: Preliminary results from our review demonstrate that lymph node yield has the potential to predict the hazard of death and recurrent disease in locally advanced HNCSCC. Further analysis of our data can provide clarity into the prognostic value of nodal yields and positive LNR.