Clinical Significance of Retropharyngeal Lymph Node Metastasis from Hypopharyngeal Squamous Cell Carcinoma

Yu, Myeong Sang; Kim, Ji Heui; Roh, Jong Lyel; Choi, Seung Ho; Kim, Sang Yoon; Nam, Soon Yuhl

Abstract

BACKGROUND AND OBJECTIVES: Little information about the incidence of retropharyngeal adenopathy and its impact on prognosis has been published. The purpose of this study is to investigate the incidence and prognostic significance of metastatic retropharyngeal adenopathy in patients with squamous cell carcinoma of the hypopharynx.
SUBJECTS AND METHOD
The pretreatment CT/MRI of 121 patients with squamous cell carcinoma of the hypopharynx were reviewed for the presence of metastatic retropharyngeal lymph nodes. All patients were treated between 1996 and 2005. The influence on recurrence (local and regional), distant metastasis, and survival was retrospectively analyzed. Mean follow-up was 28.3 months.
RESULTS
Retropharyngeal node involvement was present in 21 (17.4%) patients. The clinical T staging was the most significant factor relating to the incidence of retropharyngeal adenopathy in multivariate analysis (p=0.006). The rates of regional recurrence and distant metastasis were significantly higher in patients with retropharyngeal adenopathy. Disease specific survival rate was significantly lower in the retropharyngeal node positive group (p=0.013).
CONCLUSION
Retropharyngeal node involvement has a negative impact on the prognosis of squamous cell carcinoma of the hypopharynx. Patients are particularly at risk for distant metastasis, resulting in worse disease-specific survival. Retropharyngeal node involvement should be taken into account in designing the treatment plan for these patients.