title: Prognostic importance of paratracheal lymph node metastases.
abstract: OBJECTIVE
  The aim of this retrospective study was to evaluate the prognostic significance of paratracheal lymph node (PTLN) metastases for tumor recurrence and survival for patients treated with total laryngectomy (TL) and PTLN dissection.
  
  
  METHODS
  Records from 85 patients who underwent TL combined with PTLN dissection for laryngeal or hypopharyngeal carcinomas were reviewed.
  
  
  RESULTS
  In 20 of 85 (24%) patients, PTLN metastases were found, and in 7 patients, extranodal spread (ENS) was present in these metastases. The incidence of PTLN metastases was high in patients with hypopharyngeal or cervical esophageal (35%) and laryngeal carcinoma with subglottic extension (27%). Multivariate analysis shows that the most important prognostic factor for overall survival is the presence of PTLN metastases with ENS (P < .0005).
  
  
  CONCLUSIONS
  Because PTLN metastases with ENS is an important prognostic factor and can only be assessed by histopathologic examination, PTLN dissection in patients with a laryngeal or hypopharyngeal tumor is important for prognostication.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
authors.forename: Robin E
authors.initials: RE
authors.lastname: Plaat
authors.forename: Remco
authors.initials: R
authors.lastname: de Bree
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Kuik
authors.forename: Michiel W M
authors.initials: MW
authors.lastname: van den Brekel
authors.forename: Alexander H
authors.initials: AH
authors.lastname: van Hattum
authors.forename: Gordon B
authors.initials: GB
authors.lastname: Snow
authors.forename: C René
authors.initials: CR
authors.lastname: Leemans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D007825:Laryngectomy / Q000379:methods; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D016609:Neoplasms, Second Primary / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D014132:Trachea