title: Pattern of lymph node metastasis in hypopharyngeal squamous cell carcinoma and indications for level VI lymph node dissection.
abstract: The purpose of this study was to determine the incidence, risk factors, and prognostic significance of level VI lymph node metastases from hypopharyngeal squamous cell carcinoma (SCC).
  
  
  
  A retrospective review of 68 previously untreated patients with hypopharyngeal SCC who underwent level VI node dissection was performed.
  
  
  
  Level VI lymph node metastases occurred in 27.9% of patients. The occult metastasis rate of level VI node was 14.3%. Patients with level VI metastasis had significantly lower disease-specific (55.1% vs 26.3%) and overall survival rates (73.5% vs 31.6%). Level VI lymph node metastasis was significantly correlated with regional recurrence (83.7% vs 63.2%) and distant metastasis (67.3% vs 47.4%). Multivariate analysis revealed that pyriform sinus apex invasion (odds ratio [OR] = 5.106) was an independent factor for level VI nodal metastasis.
  
  
  
  Level VI lymph nodes should be removed in patients with pyriform sinus apex invasion, especially in those with advanced nodal disease. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1969-E1973, 2016.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Eun-Jae
authors.initials: EJ
authors.lastname: Chung
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Head and Neck Cancer Hospital, Hallym University, College of Medicine, Seoul, Korea.
authors.forename: Go-Woon
authors.initials: GW
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Head and Neck Cancer Hospital, Hallym University, College of Medicine, Seoul, Korea.
authors.forename: Bum-Ki
authors.initials: BK
authors.lastname: Cho
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Head and Neck Cancer Hospital, Hallym University, College of Medicine, Seoul, Korea.
authors.forename: Hae Sang
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Head and Neck Cancer Hospital, Hallym University, College of Medicine, Seoul, Korea.
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Rho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology*; D015994:Incidence; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: hypopharyngeal carcinoma; paratracheal lymph node; prognosis; surgery