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Paratracheal lymph node dissection, in which patients should it be performed?
Şenol Çomoğlu1, Ece Çomoğlu, Necati Enver
1Department of Otolaryngology, Medicine Faculty of İstanbul University, 34093 Fatih, Çapa, İstanbul, Turkey. drcomoglu@gmail.com.
Summary
Paratracheal lymph node metastasis, especially with extranodal spread (ENS), significantly impacts survival in advanced laryngeal and hypopharyngeal cancers. PTLN dissection is recommended for accurate prognostication.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Head and Neck Cancer Research
Background:
- Advanced laryngeal and hypopharyngeal cancers present significant treatment challenges.
- The prognostic significance of paratracheal lymph node (PTLN) metastasis in these cancers requires further elucidation.
Purpose of the Study:
- To evaluate the impact of paratracheal lymph node (PTLN) metastasis on survival outcomes in patients with advanced laryngeal and hypopharyngeal cancer.
- To determine the prognostic value of extranodal spread (ENS) in PTLN metastasis.
Main Methods:
- Retrospective analysis of medical records from 78 patients with advanced laryngeal or hypopharyngeal cancer and PTLN metastasis.
- Inclusion criteria: surgery between May 1995 and June 2008, with a mean follow-up of 23 months.
- Multivariate analysis to identify prognostic factors for overall survival.
Main Results:
- PTLN metastasis was observed in varying percentages across different subsites of laryngeal and hypopharyngeal cancer.
- Extranodal spread (ENS) was present in 11 of the 15 patients with PTLN metastasis.
- Multivariate analysis identified ENS as the most significant prognostic factor for overall survival (p<0.0005).
Conclusions:
- The presence of PTLN metastasis with ENS is a critical indicator of prognosis in advanced laryngeal and hypopharyngeal cancer.
- PTLN dissection is recommended for accurate histopathological assessment and prognostication.
- ENS detection is crucial and best achieved through pathological evaluation.
