Treatment results for 84 patients with base of tongue cancer

Yoshimoto, Seiichi; Kawabata, Kazuyoshi; Mitani, Hiroki; Yonekawa, Hiroyuki; Beppu, Teruhiko; Fukushima, Hirofumi; Sasaki, Takeshi

doi:10.1080/03655230701600053

Cited by 19 publications

(7 citation statements)

References 19 publications

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“…A limited number of prior studies have reported RPLN involvement in oropharyngeal carcinoma, with a variable incidence (Table 4) [12][13][14][20][21][22][23]34]. In our series of 402 patients, the rate of radiological RPLN involvement was 10%.…”

Section: Discussionmentioning

confidence: 55%

Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes

Iyizoba-Ebozue¹,

Murray

Arunsingh³

et al. 2019

Cancers

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The influence of retropharyngeal lymph node (RPLN) involvement on prognosis in oropharyngeal carcinoma remains poorly defined. The aim of this study was to assess the impact of RPLN involvement upon outcomes. A single-centre retrospective analysis of 402 patients with oropharyngeal carcinoma treated nonsurgically between 2010 and 2017 was performed. All had a baseline 2-[fluorine-18]-fluoro-2-deoxy-d-glucose (FDG) PET-CT and contrast-enhanced MRI and/or CT. RPLN status was determined by radiology review of cases with reported abnormal RPLN. Multivariate backwards logistic regression was used to examine impact on outcomes of factors. Abnormal RPLNs were identified in 40/402 (10%) of patients. Median follow up was 42.9 months. RPLN involvement was associated with inferior 3 year outcomes for overall survival (OS) (67.1% vs. 79.1%, p = 0.006) and distant metastases-free survival (DMFS) (73.9% versus 88.0%, p = 0.011), with no significant difference in local control (81.6% vs. 87.7%, p = 0.154) or regional control (80.7% vs. 85.4%, p = 0.252). On multivariate analysis abnormal RPLN, no concurrent chemotherapy and ongoing smoking were associated with inferior DMFS and OS, while advanced T stage was also associated with inferior OS. In summary, RPLN involvement, present in 10% of patients, was an independent prognostic factor for the development of distant disease failure translating into inferior OS. These findings need confirmation in future studies.

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Section: Discussionmentioning

confidence: 55%

Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes

Iyizoba-Ebozue¹,

Murray

Arunsingh³

et al. 2019

Cancers

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“…They found that the risk was higher for patients with posterior and lateral pharyngeal wall cancers (29% for lateral and posterior wall vs 0% for others sites). In 2007, Yoshimoto et al34 reported their series of 84 patients with base of tongue cancer. In this series, 2 patients had RPLN metastases at the time of diagnosis and 2 more developed recurrent cancer in the RPLN.…”

Section: Anatomymentioning

confidence: 99%

Retropharyngeal lymph node metastases in head and neck malignancies

et al. 2010

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Retropharyngeal lymph node (RPLN) metastasis of primary head and neck cancer often receives less consideration than lymph node metastasis in the neck. With improvements in imaging techniques and reports of surgical pathology, there is an improved understanding of the risk and subsequently the need for treatment of RPLNs. The rates of RPLN metastasis from carcinomas of the nasopharynx, oropharynx, hypopharynx, postcricoid region, maxillary sinus, and cervical esophagus are sufficiently high to warrant routine treatment, either electively or therapeutically, of this region. Through improved diagnostic techniques and heightened awareness of RPLN metastasis, patients at risk of having these metastases can be treated more effectively.

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“…Data regarding the incidence of retropharyngeal lymph node (RP LN) metastases in oropharyngeal cancer are limited due to the difficulty of surgical access [1] with pathological data based upon small series [2,3]. Imaging studies report a variable incidence (2-21%) of RP LN metastases [4][5][6][7][8][9][10][11]. MRI is superior to CT for the detection of RP LNs [1,12,13].…”

mentioning

confidence: 99%

Incidence and patterns of retropharyngeal lymph node involvement in oropharyngeal carcinoma

Iyizoba-Ebozue¹,

Murray

Arunsingh³

et al. 2020

Radiotherapy and Oncology

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Introduction: The aim was to evaluate in oropharyngeal carcinoma the: (1) incidence and predictors of retropharyngeal (RP) lymph node (LN) involvement, (2) pattern of ipsilateral/bilateral/contralateral-only RP LNs (3) location of RP LNs in relation to contouring guidelines. Methods: Single centre retrospective analysis of 402 patients with oropharyngeal carcinoma treated nonsurgically between 2010 and 2017. All patients had a baseline FDG PET-CT and contrast-enhanced MRI and/or CT. All cases with reported abnormal RP LNs underwent radiology review. Results: Abnormal RP LNs were identified in 40/402 (10%) of patients. On multivariate analysis, RP LN involvement was associated with posterior pharyngeal wall/soft palate primaries (OR 10.13 (95% CI 2.29-19.08), p = 0.002) and contralateral cervical LN involvement (OR 2.26 (95% CI 1.05-4.86), p = 0.036). T stage, largest LN size, levels of ipsilateral LN level involvement, HPV and smoking status did not predict risk. 5/402 (1.2%) patients had bilateral RP involvement. 3/402 patients (0.7%) had contralateral-only RP LNs. All patients with contralateral RP LNs had contralateral neck nodes or primary cancers extending across midline. In 5/40 (12.5%) cases with involved RP LNs, the RP LNs were superior to hard palate/upper edge of body of C1 vertebra. Conclusions: RP LNs were identified in 10% of oropharyngeal carcinoma patients, and were associated with contralateral neck disease and/or posterior pharyngeal wall/soft palate primary. Contralateral RP LN involvement was rare and associated with contralateral neck disease and/or primary crossing midline, suggesting potential for omission from target volumes for selected patients. Involvement of RP LNs close to the skull base highlights the need for generous elective outlining.

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Treatment results for 84 patients with base of tongue cancer

Cited by 19 publications

References 19 publications

Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes

Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes

Retropharyngeal lymph node metastases in head and neck malignancies

Incidence and patterns of retropharyngeal lymph node involvement in oropharyngeal carcinoma

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