Significance of Retropharyngeal Lymph Node Dissection in Hypopharyngeal Cancer

Kamiyama, Ryosuke; Saikawa, Masahisa; Kishimoto, Seiji

doi:10.1093/jjco/hyp080

Cited by 26 publications

(18 citation statements)

References 14 publications

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“…The authors also pointed out that RPLN dissection may improve the prognosis. 16 Similarly, in a study of patients with hypopharygneal and cervical esophagus cancer, Amatsu et al 17 reported that the death rate from RPLN metastasis was significantly lower than that in the RPLN dissected group.…”

Section: Discussionmentioning

confidence: 95%

“…16,17 Dirix et al 18 reported in a series of OPSCC patients that RPLN-positive group had significantly more regional recurrences and lower disease-specific survival than the negative group. McLaughlin et al 19 analyzed from their study of nonnasopharyngeal squamous cell carcinoma of the head and neck that the incidence rates of neck nodal recurrence and distant metastasis were significantly higher in the RPLN metastasis group with lower survival rate.…”

Section: Discussionmentioning

confidence: 99%

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Transoral Robotic Retropharyngeal Lymph Node Dissection With or Without Lateral Oropharyngectomy

Byeon

Duvvuri

Kim

et al. 2013

Journal of Craniofacial Surgery

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Retropharyngeal lymph node (RPLN) metastases can occur from advanced head and neck malignancies. Surgical access to RPLNs can be challenging. Considering the more aggressive conventional approach methods, there is an increasing need for minimally invasive techniques. Applying transoral robotic surgery (TORS) to access the RPLN has never been reported in the literature. The purpose of this study was to describe our experience with transoral robotic RPLN dissection for oropharyngeal and hypopharyngeal squamous cell carcinomas. We conducted a retrospective review of TORS cases performed at Severance Hospital, a tertiary care medical center from December 2011 to July 2012. Demographic, clinicopathologic, and treatment characteristics were abstracted from the medical record as well as complications and were analyzed descriptively. A total of 5 TORS procedures with transoral robotic RPLN dissection have been performed at Severance Hospital. Of these, 4 patients were treated for oropharyngeal squamous cell carcinoma and 1 for hypopharyngeal squamous cell carcinoma. The mean operation time for TORS including the robotic RPLN dissection was 84 ± 18.5 minutes. The operation time included time for docking of the robotic arms (4.8 ± 1.3 minutes), console working time for primary tumor removal (50 ± 8.9 minutes), and console working time for RPLN dissection (29.2 ± 9.4 minutes). No patients experienced complications related to the transoral robotic RPLN dissection. Transoral robotic RPLN dissection is a feasible approach for accessing retropharyngeal lymph nodes. This particular operative technique can serve as a minimal invasive surgery in removing pathologic RPLNs.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Transoral Robotic Retropharyngeal Lymph Node Dissection With or Without Lateral Oropharyngectomy

Byeon

Duvvuri

Kim

et al. 2013

Journal of Craniofacial Surgery

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show abstract

“…The 5-year overall survival rate was 50%. Although it is impossible to compare the tumor sites and draw any conclusions regarding survival, the 5-year overall survival rate was reported to be 30-53% for patients with oropharynx and hypopharynx with RPLN metastasis who had underwent RPLN dissection [11,23]. Therefore, RADPLAT, which achieved a 5-year overall survival rate of 50% and a good control rate for RPLN, is considered to be one of the opinions for patients with RPLN metastasis.…”

Section: Discussionmentioning

confidence: 99%

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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“…Based on histopathological and radiological findings, retropharyngeal metastases were found in about 13% of the patients suffering from hypopharyngeal cancers [63]. Radiologically, retropharyngeal lymph node metastases were identified in about 11% of the hypopharyngeal cancers by means of PET-CT [64].…”

Section: Direction and Extent Of Lymphogenic Metastasis Of Squamousmentioning

confidence: 99%

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

Teymoortash,

Werner

2012

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 11:Doc04; ISSN 1865-1011

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Significance of Retropharyngeal Lymph Node Dissection in Hypopharyngeal Cancer

Abstract: We recommend RPLN dissection at the time primary of treatment of hypopharyngeal cancer, especially in cases with cancer at subsites PC/PW, as RPLN dissection is expected to improve prognosis. The primary subsites PC/PW are associated with a risk of RPLN metastasis.

Cited by 26 publications

References 14 publications

Transoral Robotic Retropharyngeal Lymph Node Dissection With or Without Lateral Oropharyngectomy

Transoral Robotic Retropharyngeal Lymph Node Dissection With or Without Lateral Oropharyngectomy

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

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

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