Patterns and Clinical Significance of Nodal Metastasis in Squamous Cell Carcinoma of Hypopharynx.
10.3342/kjorl-hns.2009.52.9.756
- Author:
Young Hoon JOO
1
;
Dong Il SUN
;
Jung Hae CHO
;
Jun Ook PARK
;
Sung Hun LEE
;
Bong Jin CHOI
;
Jun Yop KIM
;
Min Sik KIM
Author Information
1. Department of Otolaryngology-HNS, School of Medicine, The Catholic University of Korea, Seoul, Korea. entkms@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Hypopharynx;
Squamous cell carcinoma;
Lymphatic metastasis;
Neck dissection
- MeSH:
Carcinoma, Squamous Cell;
Female;
Humans;
Hypopharynx;
Incidence;
Lymph Nodes;
Lymphatic Metastasis;
Male;
Neck;
Neck Dissection;
Neoplasm Metastasis;
Retrospective Studies;
Survival Rate
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
2009;52(9):756-761
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the incidence and prognostic significance of cervical lymph node metastasis in squamous cell carcinoma (SCC) of the hypopharynx. SUBJECTS AND METHOD: A retrospective review of the 64 patients who were previously untreated for SCC of the hypopharynx and underwent surgery was performed from October 1993 to June 2008. Fifty-six patients had simultaneous bilateral neck dissection, whereas eight had unilateral neck dissection. RESULTS: The median age was 61.0 years (range, 34-75 years) for the study group consisting of 62 males and two females. Evaluating according to the N stages, there were 15 (23.4%), 10 (15.6%), 37 (57.8%), and 2 (3.1%) cases with N0, N1, N2 and N3, respectively. Forty-nine patients (76.6%) had pathologically proven cervical metastasis. Contralateral occult lymph node metastasis occurred in 20.5%. Ipsilateral and contralateral occult metastasis rates for clinically node negative patients were 41.2% and 11.8%, respectively. The most frequent sites for positive neck nodes occuring at each level were as follows: II (48.5%), level III (40.6%), level IV (26.6%), paratracheal node (21.4%), level V (9.4%), levels I (7.8%), and retropharyngeal node (6.3%). The 5-year overall survival and disease-specific survival rates were 50% and 53%, respectively. Cervical nodal metastasis (p=0.044) was statistically significant prognostic factors for disease-specific survival. CONCLUSION: Metastasis to the cervical lymph node group is very frequent and has an impact on survival in patients with hypopharyngeal SCC. Therefore, we advocate bilateral neck dissection in patients with hypopharyngeal SCC with clinically positive metastasis. Ipsilateral elective neck dissection may be needed for clinically node negative patients.
