Current advances in diagnosis and surgical treatment of lymph node metastasis in head and neck cancer

Teymoortash, A.; Werner, J. A.

doi:10.3205/cto000086

Cited by 6 publications

(5 citation statements)

References 151 publications

(161 reference statements)

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“…For severe metastasis, such as that affecting the lymph nodes below the innominate vein, resulting in very enlarged lymph nodes, or resulting in fusion and close adherence to the surrounding blood vessels, it is often necessary to split the breastbone longitudinally to remove the lymph nodes. 9 …”

Section: Discussionmentioning

confidence: 99%

Thoracoscopy-assisted treatment for mediastinal metastasis of thyroid cancer: a case report

Jie

Meng

2022

J Int Med Res

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Advanced thyroid cancer with upper mediastinal lymph node metastasis is not rare in the clinical setting. For patients with severe metastasis, a thoracocervical incision is usually performed for dissection of lymph nodes. However, the difficult operation of three-port thoracoscopy to support performance of a cervical incision in the treatment of upper mediastinal lymph node metastasis has rarely been reported to date. We herein describe a case involving the treatment of thyroid cancer with upper mediastinal lymph node metastasis. The lymph node metastasis was severe, closely adhered to the innominate vein, and fused into a mass. Thoracoscopy with a cervical incision was performed and proved to be a highly difficult surgical maneuver. The patient recovered quickly after the operation. Repeat computed tomography showed no swollen metastatic lymph nodes, indicating that the dissection was thorough. Thoracoscopy with a neck incision is more difficult than conventional longitudinal split sternotomy in the treatment of upper mediastinal lymph node metastasis, but its advantages are less severe trauma and faster recovery. This procedure may be performed by surgeons with proficient skill in cervical surgery and thoracoscopy techniques.

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Section: Discussionmentioning

confidence: 99%

Thoracoscopy-assisted treatment for mediastinal metastasis of thyroid cancer: a case report

Jie

Meng

2022

J Int Med Res

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“…The deep lymphatic pathways receive lymphatic drainage from all the LNs of head and neck, whether directly or indirectly through the superficial lymphatic pathway ( 16 ). Lymphatic drainage of head and neck cancer is mainly in the deep lymphatic pathways, especially levels II, III, and IV ( 17 18 19 ). The deep lymphatic pathways merge into the right or left jugular lymphatic trunk and are drained into each subclavian vein via the thoracic duct and the right lymphatic duct ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

“… LN classification was based on the International Association for the Study of Lung Cancer LN Map ( 18 ). Percentages do not sum up to 100% because some patients had metastatic involvement of more than one cervical area.…”

Section: Figmentioning

confidence: 99%

Mediastinal Lymph Node Metastasis from Head and Neck Cancer: Predictive Factors and Imaging Features

고¹,

윤²,

백³

et al. 2021

J Korean Soc Radiol

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Purpose To assess the predictive factors and describe the imaging features of mediastinal lymph node (MLN) metastases in patients with head and neck cancer. Materials and Methods We compared the clinical features and disease characteristics (sex, age, site of primary tumor, histologic type, history of prior treatments, TNM stages, and metastasis in cervical LNs) of patients with head and neck cancers between the MLN metastasis and no MLN metastasis groups. We also evaluated the chest CT (distribution and maximum dimension of the largest LN) and PET/CT (maximum standardized uptake value) features of MLN metastases based on the MLN classification. Results Of the 470 patients with head and neck cancer, 55 (11.7%) had MLN metastasis, involving 150 mediastinal stations. Hypopharynx cancer, recurrent tumor, T4 stage, N2/N3 stages, and M1 stage were found to be significant predicting factors for MLN metastasis. The most common location of MLN metastasis was ipsilateral station 2 (upper paratracheal LNs, 36.4%), followed by ipsilateral station 11 (interlobar LNs, 27.3%) and ipsilateral station 10 (hilar LNs, 25.5%). Conclusion Metastasis to MLNs should be considered in patients with head and neck cancer, especially in cases that are associated with a hypopharyngeal cancer, recurrent tumor, and high TNM stages.

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“…Locally advanced SCCHN usually has a poor prognosis, of which the reported 5-year OS is about 50% or even lower. The majority of patients will develop LR and/or DM, especially within the first 2 years after primary therapy ( 5 , 6 ). In our research, the total LR rate was 33.3% (40/120), and the median time of LR was 8 months.…”

Section: Discussionmentioning

confidence: 99%

Three therapeutic regimens based on induction chemotherapy in locally advanced squamous cell carcinoma of the head and neck: a single center experience

Jiang¹,

Guo²,

Wang³

et al. 2020

Transl Cancer Res TCR

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Background: This study aimed to compare three different therapeutic models based on regional control and the outcome of locally advanced squamous cell carcinoma of the head and neck (SCCHN) after induction chemotherapy (ICT). Methods: One hundred and twenty patients with locally advanced SCCHN were retrospectively reviewed and divided into three groups. Patients in Group A received induction chemotherapy + concurrent chemoradiotherapy (ICT + CCRT). Patients in Group B received induction chemotherapy + radical surgery + adjuvant radiotherapy with or without chemotherapy (ICT + Surgery + RT/CRT). Patients in Group C received induction chemotherapy + planned neck dissection + concurrent chemoradiotherapy (ICT + PND + CCRT). The clinicopathological characteristics, locoregional recurrence (LR), distant metastasis (DM), and overall survival (OS) were compared among them.Results: The median follow-up time was 20 months. In Group A, Group B and Group C, the 3-year OS was 69.7%, 72.9%, and 65.5% respectively. The LR rate was 35.1%, 26.2%, and 42.9%, respectively. The DM rate was 10.5%, 31.0%, and 9.5%, respectively. There were no significant differences in OS and LR among three groups. The DM in Group B was significantly higher than that in Group A (P<0.05), and was probably higher than that in Group C (P=0.06). Conclusions:Locally advanced SCCHN has a poor prognosis, and the first treatment is critical.Individualized therapeutic regimen based on the response of ICT could be an ideal solution. As cervical metastatic lymph nodes are less sensitive to ICT than primary tumors, PND before radiation therapy might improve the regional control and throat function preservation. A multidisciplinary team (MDT) collaboration is important throughout the treatment process.

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Current advances in diagnosis and surgical treatment of lymph node metastasis in head and neck cancer

Cited by 6 publications

References 151 publications

Thoracoscopy-assisted treatment for mediastinal metastasis of thyroid cancer: a case report

Thoracoscopy-assisted treatment for mediastinal metastasis of thyroid cancer: a case report

Mediastinal Lymph Node Metastasis from Head and Neck Cancer: Predictive Factors and Imaging Features

Three therapeutic regimens based on induction chemotherapy in locally advanced squamous cell carcinoma of the head and neck: a single center experience

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