Neck and mediastinal node dissection in pharyngolaryngeal tumors

Dequanter, Didier; Shahla, M.; Boudjeltia, Karim Zouaoui; Paulus, P.; Lothaire, Philippe

doi:10.1016/j.anorl.2012.04.009

Cited by 9 publications

(9 citation statements)

References 13 publications

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“…7,9 Dequanter et al also concluded that primary tumors with PS apex invasion, or tumor diameter exceeding 3.5 cm showed a trend in favor of paratracheal lymph node involvement. 17 In contrast, the present study showed that primary tumors originating from PPW or PPW invasion showed a correlation with retropharyngeal node involvement. In agreement with pre- With low LMRs ranging from 0% to 5.1%, levels I and V were considered low risk.…”

Section: Discussioncontrasting

confidence: 97%

Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging

Wang

Zhang

et al. 2021

Precision Radiation Oncology

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Objective To investigate the frequency, distribution, and potential factors of lymphatic metastasis at each nodal level, and stratify the risk of lymph node metastasis in hypopharyngeal squamous cell carcinoma based on computed tomography. Methods Contrast‐enhanced computed tomography images of 176 patients with pathologically confirmed hypopharyngeal squamous cell carcinoma without any cancer‐related therapeutic history were analyzed retrospectively. The lymphatic metastasis ratio at each nodal level was determined. Potential factors that correlated with lymph node metastasis were identified using univariate and multivariate analyses. Results Metastatic lymph nodes were found in 145 (82.4%) of 176 patients. The lymphatic metastasis ratio was 0.6% (Ia), 4.0% (Ib), 67.6% (IIa), 43.8% (IIb), 45.5% (III), 13.1% (IV), 5.1% (Va), 1.7% (Vb), 1.7% (VIa), 12.5% (VIb), and 15.9% (VII) for each nodal level in the ipsilateral neck. In contrast, a lower lymphatic metastasis ratio was observed in the contralateral neck, with the highest measuring 18.2% at level IIa. Esophageal invasion was highly correlated with an increased risk of developing level VIb metastasis (P = 0.019). Furthermore, posterior pharyngeal wall invasion was highly correlated with an increased risk of level VII metastasis (P = 0.014). Conclusion In general, nodal levels IIa, III, and IIb were highly susceptible to metastasis in the ipsilateral neck. Nodal levels IV, VIb, and VII in the ipsilateral neck, and IIa in the contralateral neck showed a moderate risk of metastasis. Levels I and V were considered low risk. The anatomical characteristics and infiltration of tumors in different subsites should also be considered in the delineation of the clinical target volume.

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Section: Discussioncontrasting

confidence: 97%

Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging

Wang

Zhang

et al. 2021

Precision Radiation Oncology

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“…Weber et al [64] found level VIb metastases in 18% of laryngeal carcinomas, and 27% in case of subglottic extension. Level VIb metastases carry a high risk for subsequent metastasis to the superior mediastinum [65].…”

Section: Larynx (Table 4)mentioning

confidence: 99%

Selection of lymph node target volumes for definitive head and neck radiation therapy: a 2019 Update

Biau

Lapeyre

Troussier

et al. 2019

Radiotherapy and Oncology

170

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“…The author concluded that because high rate of involvement and recurrence of level VIb, systematic elective bilateral neck dissection might be needed. Previous retrospective studies [20,21] indicated that pyriform sinus apex or postcricoid invasion, or tumor diameter exceeding 3.5cm showed a trend in favor of paratracheal lymph node involvement. In our previous study, esophagus invasion was also highly correlated with increased risk of developing level VIb metastasis.…”

Section: Discussionmentioning

confidence: 96%

Patterns of regional lymph node failure of locally advanced hypopharyngeal squamous cell carcinoma after first-line treatment with surgery and/or intensity-modulated radiotherapy

Wang

Zhai

et al. 2020

Preprint

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Background: To identify the spatial patterns of regional lymph node failure of locally advanced hypopharyngeal squamous cell carcinoma (SCC) after first-line treatment with surgery and/or intensity-modulated radiotherapy (IMRT).Methods: We retrospectively obtained the clinicopathological characters of 123 hypopharyngeal SCC patients, and investigated the patterns of regional lymph node failure. Univariate and multivariate logistic regression were used to determine the risk factors of regional lymph node failure.Results: Forty patients (32.5% of total patients) were suffered regional lymph node failure. In these patients, the ipsilateral neck level II nodal failure account for 55.0% (22/40) followed by level III 30.0% (12/40), level VIb 15.0% (6/40), level VII 15.0% (6/40), and level IV 5.0% (2/40). In addition, 17.5% (7/40) patients suffered contralateral neck level II nodal failure and 7.5% (3/40) patients suffered level III nodal failure. The common failure levels were the II (7/46, 15.2%), III (4/46, 8.7%), VIb (4/46, 8.7%), and VII (5/46, 10.9%) for treatment by surgery. The lymph node recurrence and persistent disease at levels II (19/77, 24.7%) and III (10/77, 13.0%) remained the major cause of failure following curative intent of IMRT. The postoperative radiation significantly decreased the risk of regional lymph node failure (OR=0.082, 95% CI: 0.007–1.000, P=0.049); and the radiologic extranodal extension significantly increased the risk of regional lymph node failure (OR=11.07, 95% CI: 2.870–42.69, P<0.001).Conclusions: Whatever the treatment modality, the lymph node failure at level II and III was the most popular pattern for hypopharyngeal SCC. Moreover, for patients who underwent surgery, the nodal failure at level VIb and VII was frequent. Thus, postoperative radiation of level VIb and VII may give rise to benefit to locally advanced hypopharyngeal SCC patients.

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Neck and mediastinal node dissection in pharyngolaryngeal tumors

Abstract: In the present series, advanced laryngeal carcinoma was never associated with positive SM nodes, whereas advanced hypopharyngeal carcinoma showed a trend in favor of paratracheal lymph node involvement.

Cited by 9 publications

References 13 publications

Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging

Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging

Selection of lymph node target volumes for definitive head and neck radiation therapy: a 2019 Update

Patterns of regional lymph node failure of locally advanced hypopharyngeal squamous cell carcinoma after first-line treatment with surgery and/or intensity-modulated radiotherapy

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