Paratracheal lymph node dissection during total (pharyngo-)laryngectomy: A systematic review and meta-analysis

Chabrillac, Emilien; Jackson, Richard; Mattei, Pierre; D’Andréa, Gregoire; Vergez, S.; Dupret‐Bories, Agnès; Edafe, Ovie

doi:10.1016/j.oraloncology.2022.106017

Cited by 8 publications

(10 citation statements)

References 40 publications

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“…With respect to the T category of the primary tumor, there is statistically significant evidence showing that advanced T is a risk factor for CNC tumor spread. As reported in Chabrillac et al meta-analysis [29], T4 tumors were more prone to spread to PTLN compared with T3 and T2 malignancies. Similarly, Tomoika et al [33] confirmed a significant trend to PTLN metastasis for advanced cT hypopharyngeal cancers.…”

Section: T Category and Characteristicssupporting

confidence: 56%

“…In the published literature, the prevalence of PTLN metastasis results are higher for hypopharyngeal compared with laryngeal cancers [11,26,28], even though statistical significance was not detected. A recent systematic review [29] confirmed this trend; however, the statistical difference comparing the pooled data among laryngeal and hypopharyngeal carcinomas was still not significant (p = 0.157).…”

Section: Sitementioning

confidence: 97%

“…A recent meta-analysis reported an overall rate of occult nodal metastasis of 9.2%, resulting from the analysis of the only two studies in which elective PTLN dissection was performed along with salvage total laryngectomy for laryngeal SCCs [29].…”

Section: Occult Metastasismentioning

confidence: 99%

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Central Compartment Neck Dissection in Laryngeal and Hypopharyngeal Squamous Cell Carcinoma: Clinical Considerations

Deganello

Ruaro

Gualtieri

et al. 2023

Cancers

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Metastatic lymph node involvement represents the most relevant prognostic factor in head and neck squamous cell carcinomas (HNSCCs), invariably affecting overall survival, disease-specific survival, and relapse-free survival. Among HNSCCs, laryngeal and hypopharyngeal cancers are known to be at highest risk to metastasize to the central neck compartment (CNC). However, prevalence and prognostic implications related to the CNC involvement are not well defined yet, and controversies still exist regarding the occult metastasis rate. Guidelines for the management of CNC in laryngeal and hypopharyngeal cancers are vague, resulting in highly variable selection criteria for the central neck dissection among different surgeons and institutions. With this review, the authors intend to reappraise the existing data related to the involvement of CNC in laryngeal and hypopharyngeal malignancies, in the attempt to define the principles of management while highlighting the debated aspects that are lacking in evidence and consensus. Furthermore, as definition and boundaries of the CNC have changed over the years, an up-to-date anatomical–surgical description of the CNC is provided.

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Section: T Category and Characteristicssupporting

confidence: 56%

Section: Sitementioning

confidence: 97%

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Central Compartment Neck Dissection in Laryngeal and Hypopharyngeal Squamous Cell Carcinoma: Clinical Considerations

Deganello

Ruaro

Gualtieri

et al. 2023

Cancers

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“…A systematic review and meta-analysis [83 ▪▪ ] reported specifically on PTLND during (pharyngo)-laryngectomy. Ten publications were analyzed and included data on larynx, hypopharynx or cervical esophagus, and from both primary and salvage TL.…”

Section: Central Neck Compartment (Level Vi)mentioning

confidence: 99%

“…The extent of the surgery requires clarity, whether PTLN should be performed prophylactically and/or bilaterally. Few publications have reported that PTLN metastasis have been demonstrated extranodal spread [83 ▪▪ ,85].…”

Section: Central Neck Compartment (Level Vi)mentioning

confidence: 99%

Peristomal recurrence following primary total laryngectomy: the enigma of the central compartment neck lymph nodes

Bradley¹

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewThe practice of primary total laryngectomy (TL) for advanced laryngo-hypopharyngeal cancer has significantly declined in the developed countries. The treatment options most frequently adopted have changed from open surgery to transoral laser or robotic approaches or nonsurgical (bio-chemo-) radiotherapy. Primary TL remains the treatment of choice in the developing world where healthcare resources are limited, especially for the treatment of cancer. Recent findingsPeristomal recurrence (PSR) is quite a serious complication, with an incidence of 6.6% from the published literature (mainly concerning the developed world), most diagnosed within 2 years, and associated with >80% mortality. The major risk factors include pretreatment tracheostomy, specific primary tumor subsites, positive surgical margins, and presence of nodal metastasis. The treatment options are limited and most success has been observed with surgery, especially when PSR is diagnosed at an early-stage, which is uncommon. Treatment of advanced-stage disease is usually palliative. Reduction and/or prevention of the known risk factors for PSR remain the goal when performing TL. In particular, central compartment (paraand pretracheal) lymph nodes dissection in case of large tumors with extra-laryngeal and/or subglottic extension or pretreatment tracheotomy plays a paramount role in PSR prevention. SummaryResearch is required to conclude the formulation of guidelines for proper dissection of the central compartment (level VI) lymph nodes as indicated either prophylactically or therapeutically during TL for preventing PSR.

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The role of central neck dissection and adjuvant treatment in pT4aN0 laryngeal carcinoma treated with open partial horizontal laryngectomy

Bertolin,

Laura,

Cena

et al. 2024

Eur Arch Otorhinolaryngol

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Paratracheal lymph node dissection during total (pharyngo-)laryngectomy: A systematic review and meta-analysis

Cited by 8 publications

References 40 publications

Central Compartment Neck Dissection in Laryngeal and Hypopharyngeal Squamous Cell Carcinoma: Clinical Considerations

Central Compartment Neck Dissection in Laryngeal and Hypopharyngeal Squamous Cell Carcinoma: Clinical Considerations

Peristomal recurrence following primary total laryngectomy: the enigma of the central compartment neck lymph nodes

The role of central neck dissection and adjuvant treatment in pT4aN0 laryngeal carcinoma treated with open partial horizontal laryngectomy

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