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

Authors
Lim, YC; Lee, JS; Choi, EC
Citation
Acta oto-laryngologica, 129(1):57-61, 2009
Journal Title
Acta oto-laryngologica
ISSN
0001-64891651-2251
Abstract
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).
MeSH terms
AdultAgedAged, 80 and overCarcinoma, Squamous Cell/mortalityCarcinoma, Squamous Cell/pathologyCarcinoma, Squamous Cell/radiotherapyCarcinoma, Squamous Cell/surgery*Combined Modality TherapyDisease-Free SurvivalFemaleFollow-Up StudiesHumansHypopharyngeal Neoplasms/mortalityHypopharyngeal Neoplasms/pathologyHypopharyngeal Neoplasms/radiotherapyHypopharyngeal Neoplasms/surgery*Kaplan-Meier EstimateLymph Nodes/pathologyLymphatic Metastasis/pathologyMaleMiddle AgedNeck Dissection/methods*Neoplasm Recurrence, Local/mortalityNeoplasm Recurrence, Local/pathologyNeoplasm StagingRadiotherapy, Adjuvant
DOI
10.1080/00016480802001483
PMID
18607981
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Journal Papers > School of Medicine / Graduate School of Medicine > Otolaryngology
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이, 진석
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