[Surgical management of metastatic disease in the conjunctive area between neck and thorax].
OBJECTIVE
To study the surgical management of metastatic disease in the conjunctive area between the neck and thorax and its efficacy.


METHODS
Fourteen cases with metastatic node disease in the area between neck and thorax were collected and analysed. Eleven tumors were from the thyroid cancer, and the other three were from the hypopharyngeal cancer, esophagual cancer and malignant pheochromocytoma, respectively. The clavicle was displaced or resected, and the upper half of the manubrium might also be resected when necessary. The recurrent laryngeal nerve and phrenic nerve were exposed and protected. The metastatic disease was completely removed with the internal jugular and/or the brachiocephalic vein resected or spared, depending on the disease condition.


RESULTS
In 10 cases with metastases from the thyroid, no local recurrence was found within the follow-up period from 2 to 5 years. In contrast, no patient with metastatic disease from hypopharyngeal or esophageal cancer survived more than 11 months. No serious complications were found in this group.


CONCLUSIONS
The surgical treatment of node metastases in the conjunctive area between neck and thorax from the well-developed thyroid cancer has promising effect and is comparatively safe.
Wei
Bo-jun
BJ
Department of Otorhinolaryngology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China. Weibojun1015@sina.com
Zhang
Bao-quan
BQ
Zhang
Lian-shan
LS
Zhang
Zhi-yong
ZY
Yu
Hong-quan
HQ
Ge
Feng
F
Peng
Pei-hong
PH
Bai
Xiu-qing
XQ
Jiang
Hong
H
Ni
Dao-feng
DF
Yang
Shu-hua
SH
D018263:Adenocarcinoma, Follicular / Q000601:surgery*; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D037981:Neck Dissection; D013908:Thoracotomy; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy