Distribution and impact of lymph node metastases in oropharyngeal cancer

Abstract

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 than that of patients with three or more positive lymph nodes (p < 0.05). The survival rate of the patients who had ECS was significantly worse than that of the patients who had lymph node metastases but not ECS (p < 0.05). There was no significant difference between the survival rates of the patients with and without RPLN metastases.

PET‐CT Staging of the Neck in Cancers of the Oropharynx: Patterns of Regional and Retropharyngeal Nodal Metastasis

“…As previously reported, lymph node metastasis of OPSCC is most commonly seen at levels II and III [9,16,17]. PET-CT findings in this study are in agreement with this data confirming that PET-CT could accurately detect nodal disease in the staging of head and neck cancer patients.…”

“…Histology confirmed RPLN metastatic distribution was similar to our findings of PET-CT distribution where the majority (60%) were T3 and T4 tumors [9]. The epicenter of RPLN metastasis in OPSCC has been most commonly from tonsillar primary tumors, followed by posterior pharyngeal wall tumors, then base of tongue tumors [9]. Similarly, our series demonstrates tonsillar primary tumor sites to be the most common source of RPLN metastasis; however, we have found that posterior pharyngeal wall and base of tongue tumors had equal predilection for metastasis to RPLNs.…”

“…Shimizu conducted a study where RPLNs were electively dissected in cases where the primary tumor originated from or invaded the posterior or lateral wall of the oropharynx [9]. Histology confirmed RPLN metastatic distribution was similar to our findings of PET-CT distribution where the majority (60%) were T3 and T4 tumors [9]. The epicenter of RPLN metastasis in OPSCC has been most commonly from tonsillar primary tumors, followed by posterior pharyngeal wall tumors, then base of tongue tumors [9].…”

“…However, when RPLNs are treated surgically, the RPLN dissection is in conjunction with primary resection and standard neck dissection in patients with advanced carcinoma of the oropharynx and hypopharynx. RPLN dissection involves resection of this nodal basin up to the skull base along with the primary site in an en bloc fashion, using a mandibularsplitting procedure in most cases [7][8][9]. This approach divides the small nerves of the pharyngeal plexus in the process of separating the pharyngeal wall from the structures of the carotid sheath and can be associated with increased severity of dysphagia [10].…”

Aktuelle Fortschritte in der Diagnostik und chirurgischen Therapie der Halslymphknotenmetastasen bei Kopf-Hals-Karzinomen

“…In einer Untersuchung von 77 Patienten mit einem Oropharynkarzinom erfolgte neben Tumorresektion und Neck disssection die Ausräumung der retropharyngealen Lymphknoten. Es konnten histologisch bei 29 % (11/38) der Patienten mit einem Karzinom der Hinter-und Seitenwand retropharyngeale Metastasen nachgewiesen werden [ 53 ] . Histopathologisch konnten in einer weiteren Untersuchung bei 26 % der Oropharynxkarzinome retropharyngeale Lymphknotenmetastasen nachgewiesen werden [ 54 ] .…”