Open AccessNeck and Mediastinal Node Metasis
Author(s) -
Martins Antonio S.,
Del Negro André,
Tincani Alfio J.,
Casarim André M.,
Aguiar Camila G.,
Manso Daniel G.,
Fanni Renato V.
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451426a138
Subject(s) - medicine , pyriform sinus , neck dissection , larynx , metastasis , dissection (medical) , carcinoma , radiology , surgery , fistula , cancer
Objective Evaluate details of neck node metastasis (NM) and mediastinal node metastasis (MM) in carcinomas of the pharyngolaryngoesophageal (PLE) region. Method Chart review of 44 patients with gastric pull‐up for Ca of the PLE junction (cervical esophageal, hypopharyngeal and advanced laryngeal carcinomas). The mediastinal dissection (MD) resected mainly the paratracheal/paraesophageal lymph nodes down to the aortic arch. Results Fifty neck dissections (ND) were performed in 28 patients (positive nodes in 47.7%). The NM occurred in 22.2%, 60%, 70%, and 66.6% of patients with esophageal, pyriform sinus, retrocricoid, and laryngeal carcinomas, respectively. The number of neck nodes averaged 22.8 to 27.5 nodes per ND (positive in 12.5%) and was concentrated in levels II, III, and IV (84.3%). Extra capsular invasion (IE) occurred in 80.9%. Eighteen (48.6%) out of 37 patients had MM. MM occurred in 16.6%, 47.2%, and 64.2% of the patients with laryngeal, hypopharyngeal, and esophageal Ca, respectively. MD yielded 222 nodes, positive in 17%. EI occurred in 33%. Conclusion A high number of ND was done with positive nodes in most therapeutic ND and nearly 50% of selective ND. EI was high (80.9%). Selective ND may suffice in esophageal carcinomas (NM in 22.2%). MM was significant, cervical esophageal carcinomas (64.2%) occurrence of MM in 47.2% of hypopharyngeal was disturbing.