Prognostic importance of paratracheal lymph node metastases

• Published in: The Laryngoscope Vol. 115; no. 5; p. 894
• Main Authors: Plaat, Robin E, de Bree, Remco, Kuik, Dirk J, van den Brekel, Michiel W M, van Hattum, Alexander H, Snow, Gordon B, Leemans, C René
• Format: Journal Article
• Language: English
• Published: United States 01.05.2005
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - surgery; Esophageal Neoplasms - pathology; Esophageal Neoplasms - radiotherapy; Esophageal Neoplasms - surgery; Female; Humans; Hypopharyngeal Neoplasms - pathology; Hypopharyngeal Neoplasms - radiotherapy; Hypopharyngeal Neoplasms - surgery; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - radiotherapy; Laryngeal Neoplasms - surgery; Laryngectomy - methods; Lymphatic Metastasis - pathology; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasms, Second Primary - pathology; Neoplasms, Second Primary - radiotherapy; Neoplasms, Second Primary - surgery; Prognosis; Radiotherapy, Adjuvant - methods; Retrospective Studies; Trachea
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1097/01.mlg.0000160086.88523.c6

The aim of this retrospective study was to evaluate the prognostic significance of paratracheal lymph node (PTLN) metastases for tumor recurrence and survival for patients treated with total laryngectomy (TL) and PTLN dissection. Records from 85 patients who underwent TL combined with PTLN dissection for laryngeal or hypopharyngeal carcinomas were reviewed. In 20 of 85 (24%) patients, PTLN metastases were found, and in 7 patients, extranodal spread (ENS) was present in these metastases. The incidence of PTLN metastases was high in patients with hypopharyngeal or cervical esophageal (35%) and laryngeal carcinoma with subglottic extension (27%). Multivariate analysis shows that the most important prognostic factor for overall survival is the presence of PTLN metastases with ENS (P < .0005). Because PTLN metastases with ENS is an important prognostic factor and can only be assessed by histopathologic examination, PTLN dissection in patients with a laryngeal or hypopharyngeal tumor is important for prognostication.