Factors influencing contralateral metastasis and prognosis from pyriform sinus carcinoma.
BACKGROUND
The presence of neck metastasis reduces the probability of regional control and survival. The purpose of this study is to identify risk factors for contralateral neck metastasis in a series of 218 patients with pyriform sinus carcinoma.


METHODS
Tumor stages were: 31 T1-T2, 187 T3-T4, 40 N0, 174 N1-N3, and 4 NX. A total of 182 patients (83%) had metastatic lymph nodes (23 in the contralateral neck).


RESULTS
Thirty-five patients presented neck recurrences (27 in contralateral undissected neck). Logistic regression identified T and N stages, epilarynx and posterior pharyngeal wall involvement, hemilarynx fixation, and ipsilateral level 1 metastasis as important predictors of contralateral metastasis. Five-year survival rates were 41% (pN0), 23% (contralateral pN0), and 31% (contralateral positive nodes).


CONCLUSIONS
The contralateral side of the neck was the most common site of recurrence. A lateral neck dissection is advisable for the contralateral side of the neck for high-risk patients.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000556:secondary; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D007825:Laryngectomy; D016015:Logistic Models; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000473:pathology; D010611:Pharyngectomy; D011336:Probability; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate