Outcome of neck dissection for 154 cN0/cN1 patients with squamous cell carcinoma of hypopharynx and prognostic analysis
10.3760/cma.j.issn.1673-0860.2019.04.007
- VernacularTitle: 154例cN0/cN1下咽鳞状细胞癌颈淋巴清扫效果及预后分析
- Author:
Lei TAO
1
;
Liang ZHOU
1
;
Haitao WU
1
;
Ming ZHANG
1
;
Xiaoming LI
1
;
Xiaoling CHEN
1
;
Cai LI
1
;
Ming XIE
1
;
Lei CHENG
1
;
Duo ZHANG
1
Author Information
1. Department of Otorhinolaryngology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai 200031, China
- Publication Type:Journal Article
- Keywords:
Hypopharyngeal neoplasms;
Carcinoma squamous cell;
Prognosis;
Neck dissection
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2019;54(4):272-279
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the relationship between nodal disease distribution patterns and oncological outcome and optimum management of cN0/cN1 patients with hypopharyngeal squamous cell carcinoma (HPSCC).
Methods:The collected clinical data and the follow-up disease-free survival (DFS) information from 154 patients with HPSCC treated between 2001 and 2014 in Eye Ear Nose and Throat Hospital of Fudan University were retrospectively analyzed. Kaplan-Meier method was used to calculate DFS rate. Log-rank test and Cox regression model were performed to evaluate the survival prognostic factors for univariate and multivariate analyses.
Results:Among 154 patients (63 cN0 patients, 91 cN1 patients) with HPSCC,in whom 148 were male, 6 were female, with an arerage age of (58.6±9.9), 63 cN0 patients received lateral neck dissection, of whom 9 were histologically positive nodes. Particularly, occult metastasis rate was 15.6%(7/45) for HPSCC in pyriform sinus and 18.2%(2/11) for HPSCC in posterior pharyngeal wall. Among 91 cN1 HPSCC, 34 underwent radical neck dissection and 54 underwent selective neck dissection. DFS for patients(T3-4N1) with radical neck dissection was lower than that for patient with selective neck dissection(15.2% vs.39.5%, χ2=5.153, P<0.05). The DFS of cN0 HPSCC was overestimated by the false-negative patients (cN0→pN+) for cN0 HPSCC and the DFS of cN1 HPSCC was underestimated by the false-positive(cN1→pN0) for cN1 HPSCC.
Conclusions:For cN1 HPSCC, compared with radical neck dissection, selective neck dissection may be considered as a more adequate method for removal of metastatic lymph nodes. Postoperative combined therapy and follow-up strategy should be established according to pathological N staging.
