Deuss, Eric and Kuerten, Cornelius H. L. and Meyer, Moritz and Buhr, Christoph Raphael and Buenzel, Julian and Ernst, Benjamin and Mattheis, Stefan and Lang, Stephan and Timon, Timon (2024) Nodal metastasis and value of neck dissection in T1/2 oropharyngeal and hypopharyngeal carcinomas. LARYNGO-RHINO-OTOLOGIE, 103 (12). pp. 842-854. ISSN 0935-8943, 1438-8685
Full text not available from this repository. (Request a copy)Abstract
Background Due to heterogeneous data, the indication for elective neck dissection (END) in patients with squamous cell carcinoma of the hypopharynx and oropharynx (HPSCC and OPSCC) in stages T1/2N0 is somewhat unclear. Therefore, in this multicenter study, we performed detailed analysis of the metastatic behavior of HPSCC and OPSCC. Material and Methods The nodal metastatic patterns of 262 HPSCC and OPSCC patients who had undergone surgery was retrospectively investigated. In addition, recurrence-free and overall survival were recorded. Furthermore, a systematic literature review on the topic was completed. Results In patients with HPSCC, a discrepancy between clinical and pathologic N status was recorded in 62.1% of patients vs. 52.4% for p16- OPSCC, and 43.6% for p16+ OPSCC. The occult metastasis rate in cT1/2cN0 primary tumors was 38.9% for HPSCC vs. 17.8% (p16- OPSCC) and 11.1% (p16+ OPSCC). Contralateral metastases occurred in 22.2% of cases for HPSCC at stages cT1/2cN0, compared to only 9.1% for p16- OPSCC, and 0% for p16+ OPSCC patients. Patients with p16+ OPSCC had better recurrence-free and overall survival than p16- OPSCC and HPSCC patients. A direct association between patient survival and the extent of neck surgical therapy could not be demonstrated in our patients. Conclusion Patients with HPSCC are at risk for bilateral neck metastases from stage cT1/2cN0, justifying bilateral END. Patients with T1/2 OPSCC present with occult metastases ipsilaterally in >20% of cases; however, the risk for contralateral occult metastasis is <10%. Hence, in strictly lateralized cT1/2CN0 tumors, omission of contralateral END may be considered.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SQUAMOUS-CELL CARCINOMA; ELECTIVE NECK; ORAL-CAVITY; HUMAN-PAPILLOMAVIRUS; N0 NECK; CANCER; HEAD; CN0; RADIOTHERAPY; PREVALENCE; OPSCC; HPSCC; p16; cT1/2 cN0; elective neck dissection; END; early stage |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Hals-Nasen-Ohren-Heilkunde |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Dec 2025 05:59 |
| Last Modified: | 09 Dec 2025 05:59 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65012 |
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