[Selective neck dissection and the management of the hypopharyngeal cancer].
OBJECTIVE
To determine the most appropriate form of selective neck dissection(SND) in the hypopharyngeal cancer with cervical lymph node metastasis.


METHODS
We have retrospectively analyzed the distribution and prevalence of cervical metastasis in 26 patients with hypopharyngeal squamous cell carcinoma from January 1998 to December 2008. All the patients underwent SND as part of the primary treatment. There were 34 elective SNDs and 17 therapeutic SNDs from 11 node-negative hypopharyngeal cancers and others node-positive.


RESULTS
Occult metastasis was found in 6 patients (55%) with cervical metastasis confined to level II and III. Clinical node-positive necks were all pathologically identified with 6.7%, 66.7%, 86.7%, 46.7%, and 20.0% of the prevalence of metastasis to level I, II, III, IV and V respectively. The regional recurrences were found in 4 patients during the follow-up, which were all from cN+ patients. No patient experienced level I recurrence.


CONCLUSIONS
The results of this study suggest that SND (I-III) may be feasible for the treatment of cN0 hypopharyngeal cancer, which needs a larger sample to verify. Meanwhile, from our data, it has a satisfactory result to perform SND (II-V) with adjuvant radiotherapy for the cN+ patients.
Department of Otolaryngology-Head and Neck Surgery, the First Hospital of Peking University, Beijing, 100034, China.
Tiechuan
T
Cong
Enmin
E
Zhao
Shuifang
S
Xiao
Quangui
Q
Wang
Yuanding
Y
Wu
Hong
H
Shen
Tiancheng
T
Li
Yong
Y
Qin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck