Distributions of Cervical Lymph Node Metastases in Oropharyngeal Carcinoma: Therapeutic Implications for the N0 Neck

Lim, Young Chang; Koo, Bon Seok; Lee, Jin Seok; Lim, Jae Yol; Choi, Eun Chang

doi:10.1097/01.mlg.0000217543.40027.1d

Cited by 113 publications

(126 citation statements)

References 14 publications

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“…Elective neck dissection of the contralateral neck in OSCC can safely be performed as neck dissection of regions I, II, III, and IV [94][95][96]. As a limited procedure, the neck dissection has few complications or long-lasting side effects, and offers the advantage of an accurate classification [97][98] and the status of contralateral lymph nodes, which is closely linked to adjuvant treatments.…”

Section: Neck Dissectionmentioning

confidence: 99%

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma

et al. 2011

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Oral squamous cell carcinoma (OSCC) has a high incidence of cervical micrometastases and sometimes metastasizes contralaterally because of the rich lymphatic intercommunications relative to submucosal plexus of oral cavity that freely communicate across the midline, and it can facilitate the spread of neoplastic cells to any area of the neck consequently. Clinical and histopathologic factors continue to provide predictive information to contralateral neck metastases (CLNM) in OSCC, which determine prophylactic and adjuvant treatments for an individual patient. This review describes the predictive value of clinical-histopathologic factors, which relate to primary tumor and cervical lymph nodes, and surgical dissection and adjuvant treatments. In addition, the indications for elective contralateral neck dissection and adjuvant radiotherapy (aRT) and strategies for follow-up are offered, which is strongly focused by clinicians to prevent later CLNM and poor prognosis subsequently.

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Section: Neck Dissectionmentioning

confidence: 99%

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma

et al. 2011

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“…This is in keeping with lymphatic drainage of the maxilla [5,8,26,27]. Selective neck dissection of levels I, II, and III is already recommended for tumours in other locations in the oral cavity when the patient is cN0 [9,12,13]. With cancers of the hard palate, this approach is interesting, since it permits analysis of zones I-III, where we observed nodal progression with our cohort.…”

Section: Discussionmentioning

confidence: 98%

“…The reported sensitivity of this approach to diagnosing adenopathies is, however, only 90% [9,24]. Concomitant positron emission tomography (PET) could improve the accuracy of diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Metastatic nodes can be present at early stage l, and this is probably due to the dense lymphatic network in this area [8]. In the oral cavity and the oropharynx, the prevalence of nodal metastasis at initial diagnosis is about 50-60% [9], and the incidence of occult nodal metastases has been reported to be between 24 and 42% at all affected sites [10]. For the latter reason, nodal dissection and tumour resection are usually performed at the same time, even in the absence of macroscopic clinical or radiological signs (cN0), to determine the extent to which the lymph nodes may have been affected [11].…”

Section: Introductionmentioning

confidence: 99%

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Can Early Dissection of Cervical Lymph Nodes Improve Prognosis in Squamous Cell Carcinomas of the Hard Palate

Deneuve

Bodard

Delquignies

et al. 2017

ORL

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Squamous cell carcinomas of the hard palate and maxillary alveolar ridge are rare tumours with a poor prognosis. Lymph node dissection is recommended for tumours with nodal involvement, and is rarely performed in the absence of adenopathy. We report a series of patients with squamous cell carcinomas and evaluate the rate of lymph node invasion and its impact on survival. This is a retrospective study of 72 patients treated for squamous cell carcinoma of the hard palate and maxillary alveolar ridge between January 1, 1998 and December 31, 2008 in two cancer centres. Using clinical and radiological assessment, tumours were classified as T1-T2 in 25 patients (34.7%) and T3-T4 in 47 patients (65.3%). At diagnosis, 16 (22.2%) patients had clinical and/or radiological nodal involvement and 7 patients (9.7%) distal metastasis. Among N0 patients, 13 (18%) experienced isolated lymph node recurrence. Two-year global survival was 60%; 5-year survival was 34%. The rate of lymph node invasion observed in squamous cell carcinoma of the hard palate and maxillary alveolar ridge does not differ from other oral cavity sites. Because nodal recurrence worsens the prognosis of such a patient, lymph node dissection should be considered at an early stage, even among N0 patients.

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“…Concurrently, they gain access to regional lymph nodes and lymphatics, where they form new malignant clones. 29,30 Distant metastases are rare (15-20%), 31 but most affected organs are the lungs, liver and bone. 32 …”

Section: Pattern Of Spreadmentioning

confidence: 99%

Oropharyngeal cancer: an emergent disease?

Granados-García

2016

Salud Publica Mex

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ResumenEl cáncer de orofarínge recientemente ha incrementado su incidencia, por lo que ha atraído la atención pública. Como en otras neoplasias malignas de las vías aerodigestivas superiores se atribuye a los efectos carcinogénicos del tabaco y alcohol, sin embargo evidencia reciente señala un incremento substancial atribuible a los efectos del virus del papiloma humano. Mucho se ha avanzado en relación a los conocimientos de los mecanismos moleculares y genéticos implicados en la génesis y progresión de estas neoplasias, lo que ha conducido al desarrollo de nuevas y prometedoras terapias, mas especificas y menos tóxicas, que han prolongado la vida y mejorado su calidad, pero no han logrado incrementar significativamente la proporción de pacientes curados. Si se desea abatir la mortalidad por estas neoplasias es necesario emprender medidas de salud publica dirigidas a su prevención y diagnóstico temprano.Palabras clave: cáncer de cabeza y cuello; cáncer de vías aerodigestivas; cáncer de orofaringe; tabaco; alcohol; virus del papiloma humano AbstractOropharyngeal cancer incidence has recently increased, thereby attracting public attention. Akin to other malignancies of the upper aerodigestive tract, it has been attributed to the carcinogenic effects of tobacco and alcohol use. However, recent evidence shows that a substantial increase in the disease is attributable to the effects of human papillomavirus (HPV). Marked progress has been made in relation to the knowledge of molecular and genetic mechanisms involved in the genesis and progression of these cancers. This has led to the development of new and promising therapies of a more specific and less toxic nature that have prolonged life and improved its quality. However, these therapies have failed to significantly increase the proportion of patients who are cured. To decrease the mortality associated with these neoplasms, it is necessary to adopt public health measures aimed at prevention and early diagnosis.Keywords: head and neck cancer; cancer of the aerodigestive tract; oropharyngeal cancer; tobacco; alcohol; human papillomavirus EpidemiologyIn Mexico, less than 500 oropharyngeal cancer cases occur among 148 000 malignancies diagnosed each year (annual age-adjusted incidence rate of 0.

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Distributions of Cervical Lymph Node Metastases in Oropharyngeal Carcinoma: Therapeutic Implications for the N0 Neck

Abstract: These results suggest that elective N0 neck treatment in patients with oropharyngeal SCC, especially base of tongue cancer, should include neck levels II, III, and IV instead of levels I, II, and III.

Cited by 113 publications

References 14 publications

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma

Can Early Dissection of Cervical Lymph Nodes Improve Prognosis in Squamous Cell Carcinomas of the Hard Palate

Oropharyngeal cancer: an emergent disease?

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