Therapeutic selective neck dissection (level II-V) for node-positive hypopharyngeal carcinoma: is it oncologically safe?

• Published in: Acta oto-laryngologica Vol. 129; no. 1; pp. 57 - 61
• Main Authors: Lim, Young Chang, Lee, Jin Seok, Choi, Eun Chang
• Format: Journal Article
• Language: English
• Published: Stockholm Informa UK Ltd 2009; Taylor & Francis; Informa
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Combined Modality Therapy; Dermatology; Disease-Free Survival; Female; Follow-Up Studies; Humans; Hypopharyngeal Neoplasms - mortality; Hypopharyngeal Neoplasms - pathology; Hypopharyngeal Neoplasms - radiotherapy; Hypopharyngeal Neoplasms - surgery; Hypopharynx; Kaplan-Meier Estimate; Lymph Nodes - pathology; Lymphatic Metastasis - pathology; Male; Medical sciences; Middle Aged; Neck Dissection - methods; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; node-positive neck; Otorhinolaryngology. Stomatology; Radiotherapy, Adjuvant; selective neck dissection; squamous cell carcinoma; Tumors; Tumors of the skin and soft tissue. Premalignant lesions; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Skin disease; Squamous cell carcinoma; Basal cell carcinoma; ENT; selective neck dissection; Malignant tumor; Hypopharynx; Hypopharynx carcinoma; Treatment; Surgery; ENT disease; Pharynx disease; Neck; node-positive neck; Dissection; Cancer
• ISSN: 0001-6489; 1651-2251
• DOI: 10.1080/00016480802001483

Conclusions. Our study suggests that routine level I dissection may not be necessary in the surgical management of clinically N + hypopharyngeal squamous cell carcinoma (SCC) in patients who do not have a positive lymph node in neck level I. Objective. To determine whether level I lymph node dissection can be saved in patients with clinically N + hypopharyngeal SCC. Patients and methods. Retrospective analysis of 64 consecutive clinically N + patients with untreated hypopharyngeal SCC between 1994 and 2006. Forty-seven patients underwent level I lymph node dissection and the remaining 17 did not. Forty-five of the 64 patients were followed for a minimum of 2 years, if alive, or until death. Of these 45 patients, 35 underwent ipsilateral level I dissection of the neck. Results. The incidence of occult metastases to level I was 6% (3 of 47). Six (17%) of 35 patients with level I dissection and 1 (10%) of 10 patients without level I dissection experienced regional recurrence (p>0.05). The 2-year disease-specific survival in 47 patients undergoing level I neck dissection was 44% compared with 37% in 17 patients who did not undergo level I neck dissection (p>0.05).