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Peer-reviewedCC BY-NC-NDCancer immunology, immunotherapy : CII

Impact of neck nodal yield on immune checkpoint inhibitor outcome after recurrence in head and neck squamous cell carcinoma.

  • Dong Hyun Kim1,2
  • Jiwon Koh3,4
  • Yoon Kyung Jeon3,4
  • Kyeong Cheon Jung3
  • Jungirl Seok5
  • Eun-Jae Chung5
  • Seong-Keun Kwon5
  • Soon-Hyun Ahn5
  • Bhumsuk Keam6,7
7 affiliations
  1. 1Department of Internal Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Republic of Korea.
  2. 2Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
  3. 3Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea.
  4. 4Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
  5. 5Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
  6. 6Department of Internal Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Republic of Korea. [email protected].
  7. 7Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. [email protected].
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Abstract

Introduction

Neck dissection and adequate lymph node yield (LNY) are important in the treatment of head and neck squamous cell carcinoma (HNSCC). Cervical lymph nodes represent the primary sites for T-cell priming; however, the impact of LNY on the efficacy of immune checkpoint inhibitors (ICIs) remains unclear.Methods

A total of 120 patients with HNSCC who relapsed after surgical resection and subsequently received ICIs were included. The association of LNY, neutrophil-lymphocyte ratio (NLR), and programmed death-ligand 1 (PD-L1) expression with ICI outcomes were evaluated.Results

Among 120 patients, 31 underwent unilateral, 82 bilateral, and 7 no neck dissection. The median LNY was 26 (mean, 29.9; range, 0-145). PD-L1 expression was evaluated in 80 patients, 69 of whom had combined positive score ≥ 1. The low-LNY group had a higher overall response rate to ICI than the high-LNY group (42.9% vs. 16.9%, P = 0.003). Patients with high LNY had inferior PFS (median, 1.3 vs. 5.9 months; P < 0.001) and OS (median, 9.7 vs. 21.1 months; P = 0.007) compared with those with low LNY. In multivariable analysis, high LNY and high NLR were independent predictors of poor survival, whereas PD-L1 expression was not. Among patients with PD-L1-positive tumors, those with high NLR had inferior survivals compared with those with low NLR.Conclusions

Extensive lymphatic ablation, as reflected by high LNY, may be associated with diminished ICI efficacy in relapsed HNSCC. These findings suggest that LNY warrants further investigation as a potential biomarker for ICI outcomes in patients with post-surgical recurrent HNSCC.

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Cite

BibTeXRIS
BibTeX
@article{kim2026impact,
  title = {{Impact of neck nodal yield on immune checkpoint inhibitor outcome after recurrence in head and neck squamous cell carcinoma.}},
  author = {Dong Hyun Kim and Jiwon Koh and Yoon Kyung Jeon and Kyeong Cheon Jung and Jungirl Seok and Eun-Jae Chung and Seong-Keun Kwon and Soon-Hyun Ahn and Bhumsuk Keam},
  journal = {Cancer immunology, immunotherapy : CII},
  year = {2026},
  month = jul,
  doi = {10.1007/s00262-026-04504-x},
  url = {https://europepmc.org/article/MED/42902102},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Impact of neck nodal yield on immune checkpoint inhibitor outcome after recurrence in head and neck squamous cell carcinoma.
AU  - Dong Hyun Kim
AU  - Jiwon Koh
AU  - Yoon Kyung Jeon
AU  - Kyeong Cheon Jung
AU  - Jungirl Seok
AU  - Eun-Jae Chung
AU  - Seong-Keun Kwon
AU  - Soon-Hyun Ahn
AU  - Bhumsuk Keam
PY  - 2026
DA  - 2026/07/01
JO  - Cancer immunology, immunotherapy : CII
DO  - 10.1007/s00262-026-04504-x
UR  - https://europepmc.org/article/MED/42902102
AB  - Introduction  Neck dissection and adequate lymph node yield (LNY) are important in the treatment of head and neck squamous cell carcinoma (HNSCC). Cervical lymph nodes represent the primary sites for T-cell priming; however, the impact of LNY on the efficacy of immune checkpoint inhibitors (ICIs) remains unclear.Methods  A total of 120 patients with HNSCC who relapsed after surgical resection and subsequently received ICIs were included. The association of LNY, neutrophil-lymphocyte ratio (NLR), and programmed death-ligand 1 (PD-L1) expression with ICI outcomes were evaluated.Results  Among 120 patients, 31 underwent unilateral, 82 bilateral, and 7 no neck dissection. The median LNY was 26 (mean, 29.9; range, 0-145). PD-L1 expression was evaluated in 80 patients, 69 of whom had combined positive score ≥ 1. The low-LNY group had a higher overall response rate to ICI than the high-LNY group (42.9% vs. 16.9%, P = 0.003). Patients with high LNY had inferior PFS (median, 1.3 vs. 5.9 months; P < 0.001) and OS (median, 9.7 vs. 21.1 months; P = 0.007) compared with those with low LNY. In multivariable analysis, high LNY and high NLR were independent predictors of poor survival, whereas PD-L1 expression was not. Among patients with PD-L1-positive tumors, those with high NLR had inferior survivals compared with those with low NLR.Conclusions  Extensive lymphatic ablation, as reflected by high LNY, may be associated with diminished ICI efficacy in relapsed HNSCC. These findings suggest that LNY warrants further investigation as a potential biomarker for ICI outcomes in patients with post-surgical recurrent HNSCC.
SN  - 0340-7004
SN  - 1432-0851
ER  -