Impact of Lymph Node Yield in Patients Undergoing Total Laryngectomy and Neck Dissection

Objectives: To determine the impact of lymph node yield (LNY) in patients undergoing neck dissection at the time of total laryngectomy (TL). To determine the impact of radiation therapy (RT) on LNY.Methods: Retrospective review of LNY and clinical outcomes in 232 patients undergoing primary or salvage total laryngectomy (TL) with ND.Results: Preoperative RT significantly decreased mean LNY from 31.7 to 23.9 nodes (P< .001). In primary TL patients, age (P< .001) and positive margins (P= .044) were associated with decreased OS. In salvage TL patients, only positive margins was associated with poorer OS (P= .009). No LNY cutoff provided significant OS or DFS benefit.Conclusions: Radiotherapy significantly reduces LNY in patients undergoing TL and ND. Within a single institution cohort, positive margins, but not LNY, is associated with survival in both primary and salvage TL patients. Level of Evidence:4