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Neck and mediastinal node dissection in pharyngolaryngeal tumors
D Dequanter1, M Shahla, K Zouaoui Boudjeltia
1Head and Neck Department, hôpital Vésale, CHU Charleroi, rue de Gozée 706, 6110 Montigny-le-Tilleul, Belgium. Didier.dequanter@pandora.be
European Annals of Otorhinolaryngology, Head and Neck Diseases
|November 28, 2012
Summary
Superior mediastinum (SM) dissection is not necessary for advanced laryngeal squamous cell carcinoma (SCC). However, advanced hypopharyngeal SCC may benefit from SM dissection due to potential lymph node involvement.
Area of Science:
- Oncology
- Head and Neck Surgery
- Surgical Pathology
Background:
- Advanced upper aerodigestive tract squamous cell carcinoma (SCC) presents unique challenges in staging and treatment.
- The role of superior mediastinum (SM) dissection in these cases remains a subject of investigation.
Purpose of the Study:
- To evaluate the necessity of superior mediastinum (SM) dissection in advanced upper aerodigestive tract SCC.
- To determine the prognostic significance of SM lymph node metastasis in these patients.
Main Methods:
- Retrospective review of 31 patients undergoing (pharyngo-) laryngectomy for advanced SCC.
- Statistical analysis to correlate SM lymph node metastasis with clinical factors (P<0.05).
Main Results:
- 20 out of 31 patients had positive cervical and/or SM lymph nodes.
- Isolated positive SM nodes were observed in six cases.
- No laryngeal SCC cases showed positive SM nodes, while six hypopharyngeal SCC cases did (tumors >35 mm).
Conclusions:
- Advanced laryngeal SCC is not associated with positive SM nodes in this series.
- Advanced hypopharyngeal SCC shows a trend towards paratracheal lymph node involvement, suggesting potential benefit from SM dissection.
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