The impact of lymph node metastases on the results of treatment by primary radiotherapy and secondary surgery in oropharyngeal cancer.
The prognostic significance of lymph node metastases was evaluated in an unselected material of 427 oropharyngeal cancer patients treated primarily with radiotherapy. At first referral, palpable lymph node metastases were present in 60% of the patients. After irradiation, 60% of all palpable nodes had disappeared. As many as 50% of the nodes initially palpable in N3 patients vanished after irradiation. Recurrences were significantly increased in patients primarily with lymph node metastases (N1-3) compared with N0 patients; recurrences in the primary tumour site were (56% vs. 43%) in neck lymph nodes (40% vs. 9%) and in distant metastases (14% vs. 5%). Surgery was performed in 98 of 256 patients (38%) with recurrent or metastatic disease. The 5-year disease-free survival rate after radiotherapy for N0 patients was an improvement (44%) on that of N1-3 patients (23%). The N-stage is an important prognostic factor for oropharyngeal cancer patients.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate