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Review
. 2023 Jan 28;15(3):804.
doi: 10.3390/cancers15030804.

Central Compartment Neck Dissection in Laryngeal and Hypopharyngeal Squamous Cell Carcinoma: Clinical Considerations

Alberto Deganello  1 , Alessandra Ruaro  2 , Tommaso Gualtieri  3 , Giulia Berretti  3 , Vittorio Rampinelli  3 , Daniele Borsetto  4 , Sabino Russo  5 , Paolo Boscolo-Rizzo  6 , Marco Ferrari  2 , Francesco Bussu  7
Affiliations
Review

Central Compartment Neck Dissection in Laryngeal and Hypopharyngeal Squamous Cell Carcinoma: Clinical Considerations

Alberto Deganello et al. Cancers (Basel). .

Abstract

Metastatic lymph node involvement represents the most relevant prognostic factor in head and neck squamous cell carcinomas (HNSCCs), invariably affecting overall survival, disease-specific survival, and relapse-free survival. Among HNSCCs, laryngeal and hypopharyngeal cancers are known to be at highest risk to metastasize to the central neck compartment (CNC). However, prevalence and prognostic implications related to the CNC involvement are not well defined yet, and controversies still exist regarding the occult metastasis rate. Guidelines for the management of CNC in laryngeal and hypopharyngeal cancers are vague, resulting in highly variable selection criteria for the central neck dissection among different surgeons and institutions. With this review, the authors intend to reappraise the existing data related to the involvement of CNC in laryngeal and hypopharyngeal malignancies, in the attempt to define the principles of management while highlighting the debated aspects that are lacking in evidence and consensus. Furthermore, as definition and boundaries of the CNC have changed over the years, an up-to-date anatomical-surgical description of the CNC is provided.

Keywords: central neck dissection; elective neck dissection; hypopharyngeal cancer; laryngeal cancer; level VI; management; paratracheal lymph nodes dissection; prognosis; squamous cell carcinoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Anatomical diagram of the central neck compartment. The axial plane passing through the sternal notch (black dashed line) separates levels VI and VII. CCA, common carotid artery; DeN, Delphian node; H, hyoid bone; IA, innominate artery; BCV, brachiocephalic vein; PaN, paratracheal nodes; PrN, pretracheal nodes.
Figure 2
Figure 2
Panel showing a total laryngectomy specimen with en bloc dissection of the VI and VII level ipsilateral to the tumor. Several lymph nodes (*) can be observed in the paratracheal tissue.
Figure 3
Figure 3
Flow chart: indications for the elective dissection of the CNC.
See this image and copyright information in PMC

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