Distribution and impact of lymph node metastases in oropharyngeal cancer

Published on Jan 1, 2006in Acta Oto-laryngologica1.157
· DOI :10.1080/00016480500504259
Ken-Ichiro Shimizu2
Estimated H-index: 2
(Kobe University),
Hiroyuki Inoue20
Estimated H-index: 20
(Kobe University)
+ 5 AuthorsKen-ichi Nibu32
Estimated H-index: 32
(Kobe University)
Conclusions. In the treatment of oropharyngeal cancers, possible metastases to retropharyngeal lymph nodes (RPLNs) should be taken into account, especially in tumors arising in the lateral wall and/or posterior wall. Patients with multiple positive neck nodes must have intensified adjuvant therapy, especially when they have extracapsular spread (ECS). Objective. To develop optimal treatment strategies for oropharyngeal cancers, we retrospectively analyzed the lymph node metastases of oropharyngeal squamous cell carcinoma. Patients and methods. Between 1988 and 2003, 77 patients with previously untreated oropharyngeal squamous cell carcinoma underwent neck dissections. Results. Among the patients with tumor arising in the lateral wall or posterior wall, retropharyngeal nodes were involved in 29% (11/38), while RPLN metastasis was not observed in patients with tumors arising in the superior wall or anterior wall. The survival rate of patients with two or fewer positive lymph nodes was significantly better t...
📖 Papers frequently viewed together
53 Citations
420 Citations
3,211 Citations
#1Kikuo Sakamoto (Kurume University)H-Index: 10
#2Hideki Chijiwa (Kurume University)H-Index: 11
Last. Kensuke Kiyokawa (Kurume University)H-Index: 17
view all 8 authors...
1 CitationsSource
#1Mauro Andrade (USP: University of São Paulo)H-Index: 13
#2Alfredo Luiz Jacomo (USP: University of São Paulo)H-Index: 7
184 CitationsSource
#1Phillip K. Pellitteri (Geisinger Medical Center)H-Index: 30
#2Alfio Ferlito (University of Udine)H-Index: 85
Last. William I. Wei (HKU: University of Hong Kong)H-Index: 82
view all 16 authors...
In the absence of large-scale randomized trials evaluating dissection versus observation of the involved neck after neoadjuvant chemoradiotherapy, there is a need to collect data that will either support or ultimately refute a role for planned posttreatment neck dissection. A significant percentage of patients with extensive (N2 or N3) neck disease who demonstrate a complete response to chemoradiation therapy may harbor residual occult metastases, and identification of this subset of patients re...
100 CitationsSource
#1Min Yao (UI: University of Iowa)H-Index: 28
#2Kenneth J. Dornfeld (UI: University of Iowa)H-Index: 23
Last. Henry T. Hoffman (UI: University of Iowa)H-Index: 60
view all 13 authors...
Purpose: To review the University of Iowa experience with intensity-modulated radiotherapy (IMRT) in the treatment of head-and-neck squamous cell carcinoma. Methods and Materials: From October 1999 to April 2004, 151 patients with head-and-neck squamous cell carcinoma were treated with IMRT for curative intent. One patient was lost to follow-up 2 months after treatment and therefore excluded from analysis. Of the remaining 150 patients, 99 were treated with definitive IMRT, and 51 received posto...
248 CitationsSource
#1Ashok N. Reddy (Johns Hopkins University)H-Index: 3
#2David W. Eisele (UCSF: University of California, San Francisco)H-Index: 67
Last. Joseph A. Califano (Johns Hopkins University)H-Index: 89
view all 6 authors...
Objectives: A cohort of patients with small primary (T1–T2) squamous cell carcinoma of the oropharynx and advanced cervical nodal metastasis were treated with initial neck dissection(s) followed by definitive radiation therapy with or without chemotherapy. Our rationale for this algorithm and our results are examined. Study Design: Retrospective chart review. Methods: Pathology records and medical records from 1996 to 2003 from the Johns Hopkins Hospital were examined for patients meeting the in...
26 CitationsSource
#1Ted Mau (UCSF: University of California, San Francisco)H-Index: 18
#2Young S. Oh (UCSF: University of California, San Francisco)H-Index: 1
Last. David W. Eisele (UCSF: University of California, San Francisco)H-Index: 67
view all 4 authors...
Objective To assess the value of planned neck dissection in patients with a complete response to definitive radiotherapy for squamous cell carcinoma of the tonsillar fossa with advanced nodal disease. Design Case series. Setting Academic tertiary care medical center. Patients A consecutive series of 36 patients with squamous cell carcinoma of the tonsillar fossa with N2 or N3 nodal disease treated with primary radiation therapy with or without concurrent chemotherapy between January 1, 1992, and...
6 CitationsSource
#1Jacques BernierH-Index: 52
#2Christian Domenge (Institut Gustave Roussy)H-Index: 20
Last. Martine Van GlabbekeH-Index: 50
view all 14 authors...
background We compared concomitant cisplatin and irradiation with radiotherapy alone as adjuvant treatment for stage III or IV head and neck cancer. methods After undergoing surgery with curative intent, 167 patients were randomly assigned to receive radiotherapy alone (66 Gy over a period of 6 1 ⁄ 2 weeks) and 167 to receive the same radiotherapy regimen combined with 100 mg of cisplatin per square meter of body-surface area on days 1, 22, and 43 of the radiotherapy regimen. results After a med...
3,162 CitationsSource
In patients with squamous cell carcinomas of the oral cavity and the oropharynx the presence or absence of nodal metastases still is the most important predictive factor. The discriminative significance of extracapsular spread and the influence of features of the primary tumor—such as size and depth of invasion—on metastatic pattern, treatment failure and survival were evaluated. Five-year postoperative follow-ups of 115 consecutively treated patients were studied retrospectively concerning the ...
96 CitationsSource
#1Neil D. GrossH-Index: 31
#2Todd W. Ellingson (OHSU: Oregon Health & Science University)H-Index: 2
Last. Peter E. Andersen (OHSU: Oregon Health & Science University)H-Index: 44
view all 5 authors...
Background The impact of metastasis to the retropharyngeal lymph node (RPLN) group is poorly understood because of the difficult access of the retropharyngeal space. Previous studies concluding to the negative impact of RPLN metastasis rely heavily on radiographic assessment, which introduces the possibility of diagnostic error. Objective To better define the prognostic significance of metastatic retropharyngeal adenopathy in patients with non-nasopharyngeal squamous cell carcinoma of the head a...
60 CitationsSource
#1Ilana Doweck (UF: University of Florida)H-Index: 2
#2K. Thomas Robbins (UF: University of Florida)H-Index: 11
Last. Robert J. Amdur (UF: University of Florida)H-Index: 63
view all 6 authors...
Purpose. To determine the extent of the required neck dissection for patients with persistent lymphadenopathy after definitive radiation therapy for oropharyngeal cancer. If feasible, a conservative approach using selective neck dissection would likely minimize the extent of neck fibrosis and other adverse sequelae. Methods. Analysis of pretreatment and posttreatment radiologic scans and pathology reports of 76 patients with oropharyngeal carcinoma (35 tonsil; 41 base of tongue), who had radiolo...
79 CitationsSource
Cited By56
#1Smriti Panda (AIIMS: All India Institute of Medical Sciences)H-Index: 5
#2Alok Thakar (AIIMS: All India Institute of Medical Sciences)H-Index: 24
Last. Suresh C. Sharma (AIIMS: All India Institute of Medical Sciences)H-Index: 11
view all 7 authors...
Purpose Tonsil cancer being predominantly treated by non-surgical means, there is a paucity of data on lymph nodal drainage pathways and histo-pathologically confirmed metastatic rates. This study assesses the retropharyngeal lymph node (RPLN) in N0 squamous cell carcinoma tonsil as a possible first echelon node and a site for occult metastasis. Methods Prospective study involving treatment naive N0 carcinoma tonsil treated by primary surgery and adjuvant treatment from June 2017 to March 2019. ...
We present a case report of a 51-year-old left-handed male with a background of human papillomovairus 16-positive tonsil squamous cell carcinoma presenting with tonic-clonic seizure and a radiological diagnosis of secondary metastatic deposits. These were initially treated with stereotactic radiosurgery and subsequently with surgery. Surgical resection was performed under general anesthesia with right-sided temporal and parietal approaches. Both the parietal and temporal deposits were removed, w...
#2Jack C. KademianH-Index: 1
Last. Matthew E. SpectorH-Index: 26
view all 0 authors...
#1H. Mirghani (University of Paris)
#1H. Mirghani (University of Paris)
Last. P. Blanchard (Institut Gustave Roussy)
view all 2 authors...
Riassunto I cancri dell’orofaringe colpiscono ogni anno quasi 100 000 persone nel mondo. Questi cancri sono in gran parte dominati dai carcinomi epidermoidi, le cui cause principali sono l’intossicazione alcoltabagica e i papillomavirus oncogeni. Questi fattori di rischio sono responsabili di due malattie distinte, caratterizzate da meccanismi molecolari e risultati oncologici molto diversi. Questa nozione recente ci conduce progressivamente a rivisitare le nostre pratiche. La nuova edizione del...
#1H. Mirghani (University of Paris)
Last. Pierre Blanchard (Institut Gustave Roussy)H-Index: 31
view all 2 authors...
Resumen Los canceres de orofaringe afectan anualmente a cerca de 100.000 personas en todo el mundo. El mas frecuente con gran diferencia de estos canceres es el carcinoma epidermoide, cuyas causas principales son el alcoholismo/tabaquismo y los virus del papiloma oncogenos. Estos factores de riesgo provocan dos enfermedades distintas, caracterizadas por mecanismos moleculares y resultados oncologicos muy diferentes. Este concepto reciente ha motivado una revision progresiva de las practicas medi...
#1Leandros V. Vassiliou (Blackburn College)H-Index: 1
#2Julio AceroH-Index: 7
Last. Nicholas Kalavrezos (UCLH: University College Hospital)H-Index: 17
view all 9 authors...
Summary Metastasis of oral squamous cell carcinoma (OSCC) to the cervical lymph nodes has a significant impact on prognosis. Accurate staging of the neck is important in order to deliver appropriate treatment for locoregional control of the disease and for prognosis. The management of the neck in early, low volume disease (clinically T1/T2 oral cavity tumours) has long been debated. The risk of occult nodal involvement in cT1/T2 OSCC is estimated around 20-30%. We describe the natural evolutiona...
6 CitationsSource
#1M. E. Heft Neal (UM: University of Michigan)H-Index: 1
#2Julia R. Brennan (UM: University of Michigan)H-Index: 5
Last. Matthew E. Spector (UM: University of Michigan)H-Index: 26
view all 16 authors...
Background Patients with recurrent oropharyngeal cancer often require extensive salvage surgery. For patients with clinically N0 necks, the indication for concurrent neck dissection remains unclear. This study aimed to determine predictors, prevalence, and distribution of nodal disease in patients treated with salvage oropharyngectomy.
2 CitationsSource
#1Roy Xiao (Harvard University)H-Index: 13
#2Matthew C. WardH-Index: 15
Last. Brian B. Burkey (Cleveland Clinic)H-Index: 17
view all 7 authors...
BACKGROUND: We investigated the impact of level I lymph node involvement (LNI) on survival for patients with oropharyngeal squamous cell carcinoma (OPSCC). METHODS: We performed a cohort study of patients with OPSCC who underwent resection with known human papillomavirus (HPV) status in the National Cancer Database (2010-2014). RESULTS: Among 5591 patients with OPSCC, 599 (10.7%) had level I LNI. Predictors of level I LNI included pT classification (pT3 vs pT1; odds ratio [OR], 1.95; P < 0.001),...
1 CitationsSource
#1Stergios Doumas (Leeds Teaching Hospitals NHS Trust)H-Index: 6
#1S. Doumas (Leeds Teaching Hospitals NHS Trust)H-Index: 1
Last. Anastasios Kanatas (LGI: Leeds General Infirmary)H-Index: 23
view all 5 authors...
Abstract The management of enlarged retropharyngeal lymph nodes (RLN) in patients with confirmed oral, oropharyngeal, or nasopharyngeal squamous cell carcinoma (SCC) has prognostic relevance and is a challenge for the clinical teams. There is, however, no consensus regarding their clinical management or radiographic evaluation. The aim of this review therefore was to present the current thinking on management to help improve outcomes. We searched several online databases using the key terms “ret...
2 CitationsSource
#1Scott H. Troob (Columbia University)H-Index: 7
#2Babak Givi (NYU: New York University)H-Index: 16
Last. Daniel R. Clayburgh (OHSU: Oregon Health & Science University)H-Index: 20
view all 7 authors...
BACKGROUND: Assessment of the retropharyngeal lymph nodes is essential in the treatment for oropharyngeal squamous cell carcinoma (SCC). Transoral robotic retropharyngeal lymph node dissection (RPLND) may provide valuable staging information and guide selection of adjuvant therapy in a transoral robotic surgery (TORS) treatment paradigm. METHODS: Outcomes were compared between 30 patients with oropharyngeal SCC with tonsillar primaries undergoing RPLND and 37 stage-matched cases without RPLND. R...
12 CitationsSource