Impact of cervical lymph node metastasis on transoral surgery for hypopharyngeal squamous cell carcinoma: A retrospective multicenter study

Background Hypopharyngeal carcinoma is likely to spread to the lymph nodes, but there is no established strategy for management in transoral surgery. Methods We compared oncologic and functional outcomes in a retrospective multicenter study of patients who underwent transoral surgery for hypopharyng...

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Published in:Head & neck 2024-08, Vol.46 (8), p.1913-1921
Main Authors: Ushiro, Koji, Watanabe, Yoshiki, Kishimoto, Yo, Kawai, Yoshitaka, Fujimura, Shintaro, Asato, Ryo, Tsujimura, Takashi, Hori, Ryusuke, Kumabe, Yohei, Yasuda, Kaori, Tamaki, Hisanobu, Iki, Takehiro, Kitani, Yoshiharu, Kurata, Keisuke, Kojima, Tsuyoshi, Takata, Kuniaki, Kada, Shinpei, Takebayashi, Shinji, Shinohara, Shogo, Hamaguchi, Kiyomi, Miyazaki, Masakazu, Ikenaga, Tadashi, Maetani, Toshiki, Harada, Hiroyuki, Haji, Tomoyuki, Omori, Koichi
Format: Article
Language:English
Subjects:
adjuvant therapy
Cervical carcinoma
cervical lymph node metastasis
hypopharyngeal cancer
Lymph nodes
Metastases
multi‐institutional retrospective study
Radiation therapy
Squamous cell carcinoma
Surgery
Throat cancer
transoral surgery
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Summary:Background Hypopharyngeal carcinoma is likely to spread to the lymph nodes, but there is no established strategy for management in transoral surgery. Methods We compared oncologic and functional outcomes in a retrospective multicenter study of patients who underwent transoral surgery for hypopharyngeal carcinoma between 2015 and 2021. Results Two‐hundred and thirty‐two patients were included. Comparing patients with and without adjuvant radiotherapy, 3‐year regional recurrence‐free survival (RRFS) was not significantly different in pN2b and pN2c, but was significantly worse in pN3b without adjuvant radiotherapy. In patients without neck dissection, the 3‐year RRFS was 85.6%, 76.8%, and 70.0% for T1, T2, and T3 primary lesions, respectively, and was significantly worse for T2 or higher (p = 0.035). Conclusions In the absence of extracapsular invasion, regional control did not deteriorate without adjuvant therapy. If prophylactic neck dissection is not performed, careful follow‐up is necessary if the primary lesion is T2 or greater.
ISSN:1043-3074
1097-0347
1097-0347
DOI:10.1002/hed.27666