Frequency of bilateral cervical metastases in hypopharyngeal squamous cell carcinoma: a retrospective analysis of 203 cases after bilateral neck dissection

• Published in: European archives of oto-rhino-laryngology Vol. 274; no. 11; pp. 3965 - 3970
• Main Authors: Olzowy, Bernhard, Hillebrand, Matthias, Harréus, Ulrich
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2017
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - secondary; Female; Head and Neck; Head and Neck Surgery; Humans; Hypopharyngeal Neoplasms - pathology; Hypopharynx - pathology; Lymphatic Metastasis - diagnosis; Male; Medicine; Medicine & Public Health; Middle Aged; Neck Dissection; Neoplasm Micrometastasis - diagnosis; Neurosurgery; Otorhinolaryngology; Probability; Retrospective Studies; Contralateral metastases; Neck metastases; Nodal metastases; Neck dissection; Hypopharyngeal carcinoma
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-017-4724-3

The decision whether to perform an elective neck dissection in patients with head and neck squamous cell carcinoma and clinically negative lymph nodes (cN0) is made based on the probability of micrometastases in the neck for the given subsite and size of the primary. A retrospective chart review was performed of 203 patients with hypopharyngeal SCC who received a bilateral neck dissection. The frequency of histologically unveiled bilateral neck metastases was determined. A high frequency of contralateral metastases above 20% was detected for all carcinomas affecting the midline and those involving the medial wall of the pyriform sinus except of T1-stages (13%) and a low frequency for laterally located primaries (3%). Ipsilateral nodal status predicted contralateral neck metastases. Bilateral neck dissection should be recommended for primaries affecting the midline and T2–4 tumors involving the medial wall of the pyriform sinus.