Eun-Jae Chung1, Go-Woon Kim2, Bum-Ki Cho2, Hae Sang Park2, Young-Soo Rho2. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea. 2. Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Head and Neck Cancer Hospital, Hallym University, College of Medicine, Seoul, Korea.
Abstract
BACKGROUND: The purpose of this study was to determine the incidence, risk factors, and prognostic significance of level VI lymph node metastases from hypopharyngeal squamous cell carcinoma (SCC). METHODS: A retrospective review of 68 previously untreated patients with hypopharyngeal SCC who underwent level VI node dissection was performed. RESULTS: Level VI lymph node metastases occurred in 27.9% of patients. The occult metastasis rate of level VI node was 14.3%. Patients with level VI metastasis had significantly lower disease-specific (55.1% vs 26.3%) and overall survival rates (73.5% vs 31.6%). Level VI lymph node metastasis was significantly correlated with regional recurrence (83.7% vs 63.2%) and distant metastasis (67.3% vs 47.4%). Multivariate analysis revealed that pyriform sinus apex invasion (odds ratio [OR] = 5.106) was an independent factor for level VI nodal metastasis. CONCLUSION: Level VI lymph nodes should be removed in patients with pyriform sinus apex invasion, especially in those with advanced nodal disease.
BACKGROUND: The purpose of this study was to determine the incidence, risk factors, and prognostic significance of level VI lymph node metastases from hypopharyngeal squamous cell carcinoma (SCC). METHODS: A retrospective review of 68 previously untreated patients with hypopharyngeal SCC who underwent level VI node dissection was performed. RESULTS: Level VI lymph node metastases occurred in 27.9% of patients. The occult metastasis rate of level VI node was 14.3%. Patients with level VI metastasis had significantly lower disease-specific (55.1% vs 26.3%) and overall survival rates (73.5% vs 31.6%). Level VI lymph node metastasis was significantly correlated with regional recurrence (83.7% vs 63.2%) and distant metastasis (67.3% vs 47.4%). Multivariate analysis revealed that pyriform sinus apex invasion (odds ratio [OR] = 5.106) was an independent factor for level VI nodal metastasis. CONCLUSION: Level VI lymph nodes should be removed in patients with pyriform sinus apex invasion, especially in those with advanced nodal disease.