What is a lymphadenectomy?
A lymphadenectomy is a surgical procedure to dissect and remove lymph nodes. Lymph nodes are glands in your lymphatic system, a network of vessels, tissues and organs that operates throughout your body. Your lymph nodes’ job is to filter lymphatic fluid (called lymph) and remove damaged cells and cancer cells. A lymphadenectomy looks for evidence of cancer in your lymph nodes.
Why is lymphadenectomy done?
When healthcare providers recommend a lymphadenectomy, it’s usually for someone who’s already been diagnosed with cancer. Dissecting the lymph nodes in the region of the tumor is a way of discovering whether cancer has spread beyond the tumor (metastasis). This is part of the cancer staging process. Staging helps healthcare providers determine the best treatment approach.
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Who is lymphadenectomy for?
Lymphadenectomy (lymph node dissection) is recommended for people diagnosed with certain types of cancer that can spread to lymph nodes. As your lymphatic system is one of the main pathways cancer spreads through, a nearby lymph node is the most likely place it would spread to first. Dissecting and analyzing a few nodes can help reveal how far it has spread into your lymph system.
What conditions does lymphadenectomy help treat?
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Lymph node dissection is simultaneously a diagnostic procedure and a treatment. If your surgeon finds cancer cells in the lymph nodes they dissect, you can be assured that those cancer cells were removed in the process. Finding cancer there will also prompt your surgeon to look further and remove more lymph nodes if necessary. Removing the affected lymph nodes stops the cancer from spreading.
Conditions that most commonly benefit from lymphadenectomy include:
- Breast cancer.
- Melanoma.
- Head and neck cancer.
- Thyroid cancer.
- Lung cancer.
- Stomach cancer.
- Colorectal cancer.
What are the main types of lymphadenectomy?
The two main types are “regional” and “radical.” A regional (or “selective”) lymphadenectomy removes a sample of the lymph nodes local to the tumor. A radical lymphadenectomy (also called “complete” or “total” lymphadenectomy) removes all the lymph nodes in that region.
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Sometimes, surgeons begin by dissecting a single lymph node nearest to the tumor and checking to see if it has cancer. This is called a sentinel node biopsy. If this node does have cancer, your surgeon may want to remove additional nodes to check them, too.
Which lymph nodes are removed?
Lymph nodes are located in clusters throughout your body. A lymphadenectomy targets one of these clusters, based on where your cancer is located. Certain cancers tend to spread through predictable pathways, beginning with certain lymph node clusters. Each cluster has a name. Your surgeon will target those lymph nodes and dissect one, some or all of them if necessary to screen for cancer.
For example:
- An axillary lymphadenectomy dissects the axillary lymph nodes located in your armpit. This is the first place that breast cancer or melanoma of the arm typically spreads.
- An inguinal lymphadenectomy dissects the lymph nodes located in the inguinal canal on either side of your groin. Penile cancer and vulvar cancer may spread here. An inguinofemoral lymphadenectomy goes a little deeper to also target the femoral lymph nodes in the femoral canal that lies beneath the inguinal canal.
- A cervical lymphadenectomy targets the cervical lymph nodes in your neck. This type of lymph node dissection is for head, neck and thyroid cancers. (“Cervical” here refers to your cervical spine, the top of your spinal cord that runs through your neck. A cervical lymphadenectomy isn’t for cervical cancer, which is cancer of the cervix, the lower part of your uterus.)
- A retroperitoneal lymphadenectomy targets the retroperitoneal lymph nodes in the back of your abdominal cavity. This is where testicular cancer and ovarian cancer tend to spread.
- A pelvic lymphadenectomy targets the pelvic lymph nodes (also called iliac lymph nodes) located in your upper pelvis. Bladder cancer, rectal cancer and prostate cancer commonly spread here.
- A mediastinal lymphadenectomy dissects the mediastinal lymph nodes in your center chest cavity. This is where lung cancer and lymphoma may spread. Sometimes, they also spread to the supraclavicular lymph nodes in your collarbone, and your surgeon may include these as well.
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