title: [Efficacy of retropharyngeal nodes dissection in hypopharyngeal cancer].
abstract: OBJECTIVE
  To investigate the necessity and feasibility of planned dissection of the retropharyngeal lymph nodes (RPLN) in advanced hypopharyngeal cancer.
  
  
  METHODS
  Between February 2011 and December 2012, 54 patients with advanced hypopharyngeal cancer accepted planned dissection of the RPLN during primary surgery. There were 45 cases of pyriform sinus carcinoma, 5 cases of posterior pharyngeal wall carcinoma, and 4 cases of postcricoid carcinoma. All patients underwent surgery and postoperative adjuvant radiotherapy, meanwhile bilateral neck dissection and RPLN dissection were performed. All patients received preoperative CT scanning (with contrast). The results of the radiographic assessment were compared with the postoperative pathologic findings respectively.
  
  
  RESULTS
  RPLN were confirmed positive by pathology in 13 cases, and negative in another 43 cases. For the entire treatment group, metastasis to the RPLN was confirmed hispathologically in 12 patients (22.2%). Eight patients were pyriform sinus carcinoma, 4 were posterior pharyngeal wall carcinoma. Among them, seven patients were diagnosed as RPLN metastasis by CT imaging and another 5 patients were not confirmed. The overall accuracy for the radiologist's interpretation was 79.6%, the sensitivity was 58.3%, and the specificity was found to be 85.7%. Eleven patients were N2-3 and 6 patients were N2c. No RPLN metastasis or recurrence was found during more than one year follow-up period.
  
  
  CONCLUSIONS
  It is not rare for the RPLN metastasis in patients with advanced hypopharyngeal carcinoma. CT imaging is not effective in determining the early presence of RPLN metastasis. The planned dissection of the RPLN is highly recommended during the initial surgery of hypopharyngeal cancer, especially in posterior pharyngeal wall carcinoma, T3-4 pyriform sinus carcinoma and staged N2-3 cases.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China. Email: xuwhns@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China.
authors.forename: Zhenghua
authors.initials: Z
authors.lastname: Lyu
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China.
authors.forename: Jidong
authors.initials: J
authors.lastname: Zou
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China.
authors.forename: Shouhao
authors.initials: S
authors.lastname: Feng
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China.
authors.forename: Hongyuan
authors.initials: H
authors.lastname: Cao
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D008198:Lymph Nodes / Q000601:surgery; D008207:Lymphatic Metastasis; D009333:Neck; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D010610:Pharyngeal Neoplasms; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed