Abstract
Objectives: It is well established that tonsillar squamous cell carcinomas have a high probability of disseminating to the neck. An ipsilateral neck treatment is mandatory dining initial treatment of stages II to IV tonsillar carcinomas. However, as of yet, no consensus exists whether to perform elective contralateral neck management. Materials and Methods: A retrospective analysis of 43 NO-3 tonsillar cancer patients with contralateral clinically negative necks from 1092 to 2002 was performed. All patients had a contralateral elective neck dissection. Surgical treatment was followed by postoperative radiotherapy in 33 patients. The follow-up period ranged from 2 to 120 (mean 38) months. The Kaplan-Meier method and log-rank test were used to calculate the disease-specific survival rates and prognostic significance of contralateral occult lymph node metastasis. Results: Clinically negative, but pathologically positive, contralateral lymph nodes occurred in 16% (7 of 43). Of the 33 cases with an ipsilateral node positive neck, contralateral occult lymph node metastases developed in 21% (7 of 33), in contrast with 0% in ipsilateral NO necks. On the basis of the clinical staging of the tumor, 5% (1 of 22) of the cases showed lymph node metastases in T2 tumors, 36% (5 of 14) in T3, and 25% (1 of 4) in T4. None of the T1 tumors (3 cases) had pathologically positive lymph nodes (T1 + T2 vs. T3 + T4, P < .05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific survival over patients with any pathologically positive nodes (5 year disease-specific survival rate 92% vs. 28%, F = < .05). Conclusion: The risk of contralateral occult neck involvement in above T3 staged tonsillar squamous cell carcinomas with unilateral metastases was high (approximately 21%), and patients who present with a contracterai metastatic neck have a worse prognosis than those who are staged as NO. Therefore, we advocate an elective contralateral neck treatment in tonsillar squamous cell carcinoma patients with ipsilateral node metastases.
| Original language | English |
|---|---|
| Pages (from-to) | 1672-1675 |
| Number of pages | 4 |
| Journal | Laryngoscope |
| Volume | 115 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 2005 Sep 1 |
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All Science Journal Classification (ASJC) codes
- Otorhinolaryngology
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Management of contralateral N0 neck in tonsillar squamous cell carcinoma. / Lim, Young Chang; Lee, Sei Young; Lim, Jae Yol; Shin, Hyang Ae; Lee, Jin Seok; Koo, Bon Seok; Kim, Se Heon; Choi, Eun Chang.
In: Laryngoscope, Vol. 115, No. 9, 01.09.2005, p. 1672-1675.Research output: Contribution to journal › Article
TY - JOUR
T1 - Management of contralateral N0 neck in tonsillar squamous cell carcinoma
AU - Lim, Young Chang
AU - Lee, Sei Young
AU - Lim, Jae Yol
AU - Shin, Hyang Ae
AU - Lee, Jin Seok
AU - Koo, Bon Seok
AU - Kim, Se Heon
AU - Choi, Eun Chang
PY - 2005/9/1
Y1 - 2005/9/1
N2 - Objectives: It is well established that tonsillar squamous cell carcinomas have a high probability of disseminating to the neck. An ipsilateral neck treatment is mandatory dining initial treatment of stages II to IV tonsillar carcinomas. However, as of yet, no consensus exists whether to perform elective contralateral neck management. Materials and Methods: A retrospective analysis of 43 NO-3 tonsillar cancer patients with contralateral clinically negative necks from 1092 to 2002 was performed. All patients had a contralateral elective neck dissection. Surgical treatment was followed by postoperative radiotherapy in 33 patients. The follow-up period ranged from 2 to 120 (mean 38) months. The Kaplan-Meier method and log-rank test were used to calculate the disease-specific survival rates and prognostic significance of contralateral occult lymph node metastasis. Results: Clinically negative, but pathologically positive, contralateral lymph nodes occurred in 16% (7 of 43). Of the 33 cases with an ipsilateral node positive neck, contralateral occult lymph node metastases developed in 21% (7 of 33), in contrast with 0% in ipsilateral NO necks. On the basis of the clinical staging of the tumor, 5% (1 of 22) of the cases showed lymph node metastases in T2 tumors, 36% (5 of 14) in T3, and 25% (1 of 4) in T4. None of the T1 tumors (3 cases) had pathologically positive lymph nodes (T1 + T2 vs. T3 + T4, P < .05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific survival over patients with any pathologically positive nodes (5 year disease-specific survival rate 92% vs. 28%, F = < .05). Conclusion: The risk of contralateral occult neck involvement in above T3 staged tonsillar squamous cell carcinomas with unilateral metastases was high (approximately 21%), and patients who present with a contracterai metastatic neck have a worse prognosis than those who are staged as NO. Therefore, we advocate an elective contralateral neck treatment in tonsillar squamous cell carcinoma patients with ipsilateral node metastases.
AB - Objectives: It is well established that tonsillar squamous cell carcinomas have a high probability of disseminating to the neck. An ipsilateral neck treatment is mandatory dining initial treatment of stages II to IV tonsillar carcinomas. However, as of yet, no consensus exists whether to perform elective contralateral neck management. Materials and Methods: A retrospective analysis of 43 NO-3 tonsillar cancer patients with contralateral clinically negative necks from 1092 to 2002 was performed. All patients had a contralateral elective neck dissection. Surgical treatment was followed by postoperative radiotherapy in 33 patients. The follow-up period ranged from 2 to 120 (mean 38) months. The Kaplan-Meier method and log-rank test were used to calculate the disease-specific survival rates and prognostic significance of contralateral occult lymph node metastasis. Results: Clinically negative, but pathologically positive, contralateral lymph nodes occurred in 16% (7 of 43). Of the 33 cases with an ipsilateral node positive neck, contralateral occult lymph node metastases developed in 21% (7 of 33), in contrast with 0% in ipsilateral NO necks. On the basis of the clinical staging of the tumor, 5% (1 of 22) of the cases showed lymph node metastases in T2 tumors, 36% (5 of 14) in T3, and 25% (1 of 4) in T4. None of the T1 tumors (3 cases) had pathologically positive lymph nodes (T1 + T2 vs. T3 + T4, P < .05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific survival over patients with any pathologically positive nodes (5 year disease-specific survival rate 92% vs. 28%, F = < .05). Conclusion: The risk of contralateral occult neck involvement in above T3 staged tonsillar squamous cell carcinomas with unilateral metastases was high (approximately 21%), and patients who present with a contracterai metastatic neck have a worse prognosis than those who are staged as NO. Therefore, we advocate an elective contralateral neck treatment in tonsillar squamous cell carcinoma patients with ipsilateral node metastases.
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U2 - 10.1097/01.mlg.0000184791.68804.0b
DO - 10.1097/01.mlg.0000184791.68804.0b
M3 - Article
C2 - 16148715
AN - SCOPUS:24944477676
VL - 115
SP - 1672
EP - 1675
JO - Laryngoscope
JF - Laryngoscope
SN - 0023-852X
IS - 9
ER -