Lymphatic Metastases to Level IIb in Hypopharyngeal Squamous Cell Carcinoma

Abstract

To evaluate the prevalence of level IIb lymph node (LN) metastasis and to identify potential clinical risk factors when level IIb metastatic diseases are present in patients with clinically node-negative (N0) and nodepositive (Nϩ) necks with hypopharyngeal squamous cell carcinoma (HPSCC). This will provide a basis for determining whether this region can be excluded in elective or therapeutic neck dissection in patients with HPSCC. Design: Prospective analysis of a case series. Setting: University hospital. Patients: Fifty patients with HPSCC who underwent surgical treatment for a primary lesion and simultaneous neck dissection from January 1998 to February 2004. Main Outcome Measures: The incidences and clinical risk factors for level IIb LN metastasis and regional recurrence according to the presence or absence of pathologic LN involvement in level IIb.

Evaluating the significance of level IIb neck dissection for hypopharyngeal cancer

“…Details of the cases with level IIb metastases were analyzed in this study; metastasis at level IIb was observed in cases with multiple node‐positive cases similar to results in the previous reports; in addition, we examined the primary tumor site in metastasis‐positive cases at level IIb. In previous reports, details regarding the primary tumor site in such cases were omitted.…”

Level IIB lymph node metastasis in laryngeal and hypopharyngeal squamous cell carcinoma: Single‐institution case series and review of the literature

“…The larynx and hypopharynx primarily drain to LNs in levels II, III, and IV, but the role of level IIB LNs in laryngeal and hypopharyngeal metastasis is less clear. We summarized findings of 18 studies, including the current study, that presented sufficient data on level IIB LN metastasis in L‐SCC and HP‐SCC (Table ) . The cumulative rate of level IIB metastasis in L‐SCC was 3.9% (cN0, 1.7%; cN + , 11.4%).…”

“…We identified 17 additional studies from the international literature that evaluated level IIB LN metastasis in L‐SCC or HP‐SCC (or both; Table ). Six studies included only patients with L‐SCC, two studies included only patients with HP‐SCC, and the remaining studies included patients with head and neck cancer at multiple sites and various histolopathologies …”

Dissection of the submuscular recess (sublevel IIb) in squamous cell cancer of the upper aerodigestive tract: Prospective study and systematic review of the literature

“…The review identified 14 articles (excluding the data from this study) suitable for inclusion. 4,6,[8][9][10][11][12][13][14][15][16][17][18][19] To ensure uniformity of interpretation, although 2 studies 14,17 used molecular markers to identify metastatic nodes, the figures obtained from standard histologic analysis only were used for the purposes of the review. Summary findings from these studies are set out in Table 2.…”