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[Nodal metastasis and value of neck dissection in T1/2 oropharyngeal and hypopharyngeal carcinomas].
- Source :
-
Laryngo- rhino- otologie [Laryngorhinootologie] 2024 Jun 03. Date of Electronic Publication: 2024 Jun 03. - Publication Year :
- 2024
- Publisher :
- Ahead of Print
-
Abstract
- Background: Due to heterogeneous data, the indication for elective neck dissection (END) in patients with squamous cell carcinoma of the hypopharynx and oropharynx (HPSCC and OPSCC) in stages T1/2N0 is somewhat unclear. Therefore, in this multicenter study, we performed detailed analysis of the metastatic behavior of HPSCC and OPSCC.<br />Material and Methods: The nodal metastatic patterns of 262 HPSCC and OPSCC patients who had undergone surgery was retrospectively investigated. In addition, recurrence-free and overall survival were recorded. Furthermore, a systematic literature review on the topic was completed.<br />Results: In patients with HPSCC, a discrepancy between clinical and pathologic N status was recorded in 62.1% of patients vs. 52.4% for p16- OPSCC, and 43.6% for p16+ OPSCC. The occult metastasis rate in cT1/2cN0 primary tumors was 38.9% for HPSCC vs. 17.8% (p16- OPSCC) and 11.1% (p16+ OPSCC). Contralateral metastases occurred in 22.2% of cases for HPSCC at stages cT1/2cN0, compared to only 9.1% for p16- OPSCC, and 0% for p16+ OPSCC patients.Patients with p16+ OPSCC had better recurrence-free and overall survival than p16- OPSCC and HPSCC patients. A direct association between patient survival and the extent of neck surgical therapy could not be demonstrated in our patients.<br />Conclusion: Patients with HPSCC are at risk for bilateral neck metastases from stage cT1/2cN0, justifying bilateral END. Patients with T1/2 OPSCC present with occult metastases ipsilaterally in >20% of cases; however, the risk for contralateral occult metastasis is <10%. Hence, in strictly lateralized cT1/2CN0 tumors, omission of contralateral END may be considered.<br />Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.<br /> (Thieme. All rights reserved.)
Details
- Language :
- German
- ISSN :
- 1438-8685
- Database :
- MEDLINE
- Journal :
- Laryngo- rhino- otologie
- Publication Type :
- Academic Journal
- Accession number :
- 38830380
- Full Text :
- https://doi.org/10.1055/a-2291-9979