Prevalence and prognostic impact of retropharyngeal lymph nodes metastases in oropharyngeal squamous cell carcinoma: Meta‐analysis of published literature

Abstract

Background: This systematic review and meta-analysis aims to estimate the prevalence and prognostic impact of retropharyngeal lymph node metastases (RLNMs) in oropharyngeal squamous cell carcinoma (OPSCC). Methods: This meta-analysis was conducted according to PRISMA guidelines.Inclusion criteria: studies with more than 20 patients reporting the prevalence or prognostic impact of RLNMs in OPSCC. Whenever available, data on HPV status and subsites were extracted.Results: Twenty-two articles were included. The overall prevalence of RLNMs in OPSCC was 13%, with no significant differences depending on HPV status.The highest prevalence was observed for posterior pharyngeal wall SCC (24%), followed by soft palate (17%), palatine tonsil (15%), and base of tongue (8%). RLNMs were associated with a significantly higher risk of death (HR:2.54; IC95%1.89-3.41) and progression (HR:2.44;IC95%1.80-3.30). Conclusions: The prevalence of RLNMs in OPSCC was 13%, being higher in tumors of the posterior pharyngeal wall. RLNMs were associated with unfavorable outcomes.

Personalized precision radiotherapy and its evolving role for human papillomavirus-positive oropharyngeal cancer

“…Based on a recent meta-analysis of 23 studies, for OPC, the rate of retropharyngeal (RP) node, level VIIa, involvement is about 13% overall, but varies considerably by subsite, with tumors of the posterior pharyngeal wall being the most likely to spread to the RP nodes (24%), followed by the soft palate (17%), palatine tonsil (15%), and finally the base of tongue (8%). 41 In addition to the anatomical subsite, the risk of RP node involvement has also been associated with bilateral nodal involvement and the total number of involved nodes, representing another factor that should be taken into consideration when considering which regions may be spared in the planning process. 42 , 43 , 44 …”