Pattern of cervical lymph node metastasis in tonsil cancer: Predictive factor analysis of contralateral and retropharyngeal lymph node metastasis

Chung, Eun‐Jae; Oh, Jin Seok; Choi, Kyu Young; Lee, Dong Jin; Park, Il Seok; Kim, Jin Hwan; Rho, Young Soo

doi:10.1016/j.oraloncology.2011.05.013

Cited by 54 publications

(51 citation statements)

References 9 publications

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“…4.2 and 4.3 ) (King et al 2000 ;McLaughlin et al 1995 ). This practice is consistent with the recent cooperative group consensus guidelines for CTV delineation and is supported by surgical series of RP node involvement, other institutional case reports of marginal RP failures near the skull base, and RT series demonstrating an absence of RP nodal failures following IMRT using elective CTVs extending to the skull base (Chen et al 2011 ;Chung et al 2011 ;Coskun et al 2011 ;Eisbruch et al 2004a ;Gregoire and Levendag ;Hasegawa and Matsuura 1994 ). One recent preliminary report, however, suggested that in selected cases of ipsilateral-only nodal involvement, treatment of the contralateral RP nodes can be avoided without an increased risk of marginal or out-of-fi eld failure (Spencer et al 2012 ).…”

Section: Retropharyngeal Nodessupporting

confidence: 79%

“…Radiotherapy dose to the swallowing structures, specifi cally the pharyngeal constrictor (PC) muscles, has been implicated as a primary treatment-related predictor of swallowing dysfunction after chemoradiotherapy (Eisbruch et al 2011 ;Popovtzer et al 2009 ). Therefore, avoidance of dose to the PCs should be attempted where possible, although this goal must be balanced against the need for adequate coverage of the RP nodes, due to their frequent involvement in cancers of the nasopharynx, oropharynx, and hypopharynx (Chung et al 2011 ;Coskun et al 2011 ;Eisbruch et al 2004a ;Hasegawa and Matsuura 1994 ;King et al 2000 ). The RP nodes consist of lateral and medial groups, with the medial RPs located near midline close to the center of the PCs.…”

Section: Preservation Of the Swallowing Structuresmentioning

confidence: 99%

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Head and Neck Cancer

Vainshtein¹,

Eisbruch²

2015

Target Volume Definition in Radiation Oncology

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Section: Retropharyngeal Nodessupporting

confidence: 79%

Section: Preservation Of the Swallowing Structuresmentioning

confidence: 99%

Head and Neck Cancer

Vainshtein¹,

Eisbruch²

2015

Target Volume Definition in Radiation Oncology

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“…Since Ballantyne reported that RPLN metastases is associated with poor prognosis in patients with pharyngeal wall cancer [7], several reports have suggested that the control of neck metastases, distant metastases, and survival rates are significantly associated with RPLN metastases [1,[7][8][9][10] RPLNs are considered to act as the first echelon of lymphatic drainage for the nasopharynx, paranasal sinuses, oropharynx and hypopharynx [7,12,13]. Metastatic involvement of the lateral retropharyngeal nodes may lead to secondary invasion and compression of the carotid sheaths [14].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Metastatic involvement of the lateral retropharyngeal nodes may lead to secondary invasion and compression of the carotid sheaths [14]. Actually, there are several reports that advocate the dissection of the RPLNs during initial surgery in advanced tumors of the oropharynx, hypopharynx and cervical esophagus [9][10][11][14][15][16]. However, therapeutic RPLN dissection is technically challenging because of the limited surgical field and adhesion of the RPLNs to the surrounding tissue [14].…”

mentioning

confidence: 99%

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Effectiveness of superselective intra-arterial chemoradiotherapy targeting retropharyngeal lymph node metastasis

Suzuki

Sakashita

Homma

et al. 2016

Eur Arch Otorhinolaryngol

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Objective. We sought to evaluate the efficacy and feasibility of superselective intra-arterial infusion of high-dose cisplatin with concomitant radiotherapy (hereafter RADPLAT) for head and neck squamous cell cancer (hereafter HNSCC) patients with retropharyngeal lymph node (hereafter RPLN) metastasis. Study Design. Retrospective case series reviewSetting. University medical center in Japan Subjects and Methods. Ten HNSCC patients with RPLN metastasis treated by RADPLAT were analyzed.Results. The ascending pharyngeal artery was targeted for the treatment of RPLN metastasis in 9 patients. The median total dose of cisplatin was 26.6 mg/m2 (mean, 31.5 mg/m2; range, 11.7-87.9 mg/m2). In the remaining patient, the RPLN was supplied by the ascending palatine artery. As grade 3 and 4 adverse effects, leukopenia was observed in three, mucositis in four and nausea in one patient. No neurological complications were observed in any patients. Metastatic RPLNs were evaluated as a complete response in all patients. There was no recurrence of RPLN metastasis in any patients. Four patients remain alive without any evidence of disease and six patients died of disease. The 5-year overall survival rate was 50%.Conclusions. We have shown that superselective intra-arterial cisplatin infusion for RPLNs was a feasible and 2 effective approach for HNSCC patients with RPLN metastasis. INTRODUCTIONRetropharyngeal lymph node (RPLN) metastasis is considered to be a significant predictor of poor prognosis for patients with head and neck squamous cell carcinomas (HNSCCs) [1,2]. RPLN dissection is relatively simple and takes only a few minutes when performed electively. On the other hand, gross involvement of the RPLNs by the tumor can make the operation difficult and, at times, not feasible [3].Recently, superselective intra-arterial chemotherapy in combination with concomitant radiotherapy (RADPLAT) has been performed for patients with locally advanced HNSCC and has been reported to result in a favorable outcome, preserving function and improving survival [4,5]. We considered RADPLAT to be applicable to the treatment of RPLN metastasis and, therefore, assessed the efficacy and feasibility of this non-surgical treatment for HNSCC patients with RPLN metastasis. MATERIALS AND METHODSPatients. Two hundred thirty-five patients with untreated HNSCCs underwent RADPLAT in Hokkaido University Hospital, Japan between September 1999 and July 2012. In this study, we analyzed ten patients who 3 had RPLN metastasis. The primary tumor sites were the hypopharynx in six, the maxillary sinus in two, and the oropharynx in two patients. Eight patients were diagnosed with Stage IVA, one with Stage IVB, the remaining patient with stage III. Other detailed characteristics are shown in Table 1 Cisplatin infusion mainly targeted the primary tumor, RPLNs and sometimes metastatic lymph nodes. At the same time, sodium thiosulfate (20-24 g) was given intravenously to neutralize cisplatin toxicity [6]. All arterial catheterizations were accomplished transcutaneo...

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The Significance of Retropharyngeal Nodes in Treatment Deintensification

Gourin

2016

JAMA Otolaryngol Head Neck Surg

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Pattern of cervical lymph node metastasis in tonsil cancer: Predictive factor analysis of contralateral and retropharyngeal lymph node metastasis

Cited by 54 publications

References 9 publications

Head and Neck Cancer

Head and Neck Cancer

Effectiveness of superselective intra-arterial chemoradiotherapy targeting retropharyngeal lymph node metastasis

The Significance of Retropharyngeal Nodes in Treatment Deintensification

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