하인두 편평상피암종의 경부 림프절 전이의 유형 및 의의 (Patterns and Clinical Significance of Nodal Metastasis in Squamous Cell Carcinoma of Hypopharynx)

서지정보

· 발행기관 : 대한이비인후과학회
· 수록지 정보 : 대한이비인후-두경부외과학회지 / 52권 / 9호 / 756 ~ 761페이지
· 저자명 : 주영훈, 선동일, 조정해, 박준욱, 이성훈, 최봉진, 김준엽, 김민식

초록

Background and Objectives The aim of this study was to evaluate the incidence and prognostic
significance of cervical lymph node metastasis in squamous cell carcinoma (SCC) of the hypopharynx.
Subjects and Method A retrospective review of the 64 patients who were previously untreated
for SCC of the hypopharynx and underwent surgery was performed from October 1993
to June 2008. Fifty-six patients had simultaneous bilateral neck dissection, whereas eight had
unilateral neck dissection.
Results The median age was 61.0 years (range, 34-75 years) for the study group consisting
of 62 males and two females. Evaluating according to the N stages, there were 15 (23.4%), 10
(15.6%), 37 (57.8%), and 2 (3.1%) cases with N0, N1, N2 and N3, respectively. Forty-nine patients
(76.6%) had pathologically proven cervical metastasis. Contralateral occult lymph node
metastasis occurred in 20.5%. Ipsilateral and contralateral occult metastasis rates for clinically
node negative patients were 41.2% and 11.8%, respectively. The most frequent sites for positive
neck nodes occuring at each level were as follows: II (48.5%), level III (40.6%), level IV
(26.6%), paratracheal node (21.4%), level V (9.4%), levels I (7.8%), and retropharyngeal node
(6.3%). The 5-year overall survival and disease-specific survival rates were 50% and 53%, respectively.
Cervical nodal metastasis (p=0.044) was statistically significant prognostic factors
for disease-specific survival.
Conclusion Metastasis to the cervical lymph node group is very frequent and has an impact on
survival in patients with hypopharyngeal SCC. Therefore, we advocate bilateral neck dissection
in patients with hypopharyngeal SCC with clinically positive metastasis. Ipsilateral elective
neck dissection may be needed for clinically node negative patients.

영어초록

Background and Objectives The aim of this study was to evaluate the incidence and prognostic
significance of cervical lymph node metastasis in squamous cell carcinoma (SCC) of the hypopharynx.
Subjects and Method A retrospective review of the 64 patients who were previously untreated
for SCC of the hypopharynx and underwent surgery was performed from October 1993
to June 2008. Fifty-six patients had simultaneous bilateral neck dissection, whereas eight had
unilateral neck dissection.
Results The median age was 61.0 years (range, 34-75 years) for the study group consisting
of 62 males and two females. Evaluating according to the N stages, there were 15 (23.4%), 10
(15.6%), 37 (57.8%), and 2 (3.1%) cases with N0, N1, N2 and N3, respectively. Forty-nine patients
(76.6%) had pathologically proven cervical metastasis. Contralateral occult lymph node
metastasis occurred in 20.5%. Ipsilateral and contralateral occult metastasis rates for clinically
node negative patients were 41.2% and 11.8%, respectively. The most frequent sites for positive
neck nodes occuring at each level were as follows: II (48.5%), level III (40.6%), level IV
(26.6%), paratracheal node (21.4%), level V (9.4%), levels I (7.8%), and retropharyngeal node
(6.3%). The 5-year overall survival and disease-specific survival rates were 50% and 53%, respectively.
Cervical nodal metastasis (p=0.044) was statistically significant prognostic factors
for disease-specific survival.
Conclusion Metastasis to the cervical lymph node group is very frequent and has an impact on
survival in patients with hypopharyngeal SCC. Therefore, we advocate bilateral neck dissection
in patients with hypopharyngeal SCC with clinically positive metastasis. Ipsilateral elective
neck dissection may be needed for clinically node negative patients.

참고자료

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