How many lymph nodes are typically removed during a neck dissection for head and neck cancer?

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BruceCampbellMD (Physician (Verified) ) - 08 / 29 / 2012

This varies greatly from surgical case to surgical case. In the “good old days,” (before 1970), almost all neck dissections were “radical neck dissections.” This meant that all of the lymph nodes, major muscles, shoulder movement nerves, and jugular veins were removed from the level of the jaw to the level of the collar bone. Today, “selective” neck dissections tend to focus more tightly on removing only the nodes that are at risk for spread.

Neck dissections are done for three reasons: To remove known cancerous lymph nodes. To remove lymph nodes at highest risk of having cancer. To allow surgical access to other anatomy.

The neck dissection is done to gain the most information possible on the cancer’s ability to spread and to allow for informed decision making. For example, if a patient has a small cancer completely removed and all of the nodes are free of cancer, there might not be any need for further treatment such as radiation therapy. If, however, the same patient has a small cancer and has a couple of lymph nodes with cancer in them or cancer that has grown into the surrounding tissues, radiation is almost always recommended.

So, to answer your question, it is common to removed 15 to 30 lymph nodes during a neck dissection for laryngeal cancer. Removing fewer or more does not seem to have any effect on the outcome. Anatomists tell us that there are 100 to 200 lymph nodes in the neck, so even with the more comprehensive neck dissection, we are removing only a percentage of the total number.
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