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Updated: Aug 19, 2026
A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma
Published on: January 5, 2017
Factors influencing contralateral metastasis and prognosis from pyriform sinus carcinoma
L P Kowalski1, C R Santos, J Magrin
1Department of Head and Neck Surgery, Hospital A.C. Camargo, Fundação Antonio Prudente, São Paulo, Brazil.
Background:
The presence of neck metastasis reduces the probability of regional control and survival. The purpose of this study is to identify risk factors for contralateral neck metastasis in a series of 218 patients with pyriform sinus carcinoma.
Patients And Methods:
Tumor stages were: 31 T1-T2, 187 T3-T4, 40 N0, 174 N1-N3, and 4 NX. A total of 182 patients (83%) had metastatic lymph nodes (23 in the contralateral neck).
Results:
Thirty-five patients presented neck recurrences (27 in contralateral undissected neck). Logistic regression identified T and N stages, epilarynx and posterior pharyngeal wall involvement, hemilarynx fixation, and ipsilateral level 1 metastasis as important predictors of contralateral metastasis. Five-year survival rates were 41% (pN0), 23% (contralateral pN0), and 31% (contralateral positive nodes).
Conclusions:
The contralateral side of the neck was the most common site of recurrence. A lateral neck dissection is advisable for the contralateral side of the neck for high-risk patients.
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