dawnd
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Posts:13
It was recently brought to my attention that there are a whole lot more than 23 lymph nodes on one side of the neck. If only 23 are removed and only one had cancer is it possible that a remaining node could of had cancer. We are dealing with adenosquamous of the larynx and I just worry because even though he had rads/chemo what I have read is that this cancer does not respond well to treatment, surgery is the best option (which he did have). From the few studies published it looks like those with surgery vs. those with surgery and radiation have a similar survival rate.
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Reply # - November 6, 2012, 03:15 PM
Reply To: Neck dissection – only 23 removed
Dawn,
Below is a link to a post by Dr. Weiss about neck dissection. I hope it will be helpful.
http://cancergrace.org/hnscc/2010/06/10/elective-neck-dissection—just-a-pain-in-the-neck-or-a-necessary-part-of-care/
There are also several other blog/posts on the subject of head and neck cancer in the "Focused Cancer Info" link in the larger green column above.
I will contact a doctor for further input.
I hope all goes very well,
Janine
forum moderator
Reply # - November 6, 2012, 10:20 PM
Reply To: Neck dissection – only 23 removed
Dr. Jared Weiss will likely be the most helpful person to cover your question. We'll hope to get his input by tomorrow. Like many of the other docs who participate on this site, I focus on lung cancer and really don't treat enough head and neck cancer to offer the authoritative answer you'd be looking for.
-Dr. West
Reply # - November 7, 2012, 06:15 PM
Reply To: Neck dissection – only 23 removed
Dawnd,
You didn’t give a history for your loved one’s cancer. But, if I understand your post correctly, a male loved on of yours had adenosquamous of the larynx and was treated with surgery that included resection of 23 nodes, followed by adjuvant chemoradiation. If I have this wrong, please correct me and I’ll happily amend my informational comments.
First, let’s start with adenosquamous histology. The most common histology for larynx cancer is squamous cell carcinoma. The word “adenosquamous” implies that there are some features of the cancer cells that resemble adenocarcinoma, but when I see a patient with this diagnosis, it’s one that I typically review the slides myself and discuss with the pathologist. For the most part, it’s treated similar to the more common “simple” squamous cell carcinoma.
There is active discussion over how much neck dissection is necessary. Many ENT surgeons are moving towards more and more limited dissection with mounting data for safety of this. 23 nodes is actually a fairly extensive dissection.
After surgery, for patients with one or more positive node, radiation is standard. The harder question is often whether chemo should be added. Our best data tell us that we should add it for positive margins and extracapsular extension (lymph nodes have a shell; this is when cancer extends beyond this shell). We don’t yet know for sure if chemo can help lower the recurrence risk from other states thought to be higher risk, such as adenosquamous histology, multiple positive nodes, lymphovascular invastion or perinueral invasion (these last 2 are pathologic features).