title: Usefulness of radiologic examinations for diagnosing level VI lymph node metastasis in patients with laryngohypopharyngeal carcinoma.
abstract: The aim of this study was to estimate the usefulness of imaging modalities for diagnosing level VI lymph node metastasis in patients with laryngohypopharyngeal cancer. A retrospective review of 138 patients with squamous cell carcinoma of the larynx or hypopharynx who underwent central compartment neck dissection (CCND) was performed. Level VI metastasis occurred in 29 of 138 (21 %) patients. CT accuracy and sensitivity for level VI lymph node was 85.5 and 48.3 %, respectively. Respective values for MRI, US, and PET were 84.4 and 41.4 %, 87.7 and 44.8 %, and 81.2 and 34.5 %. CT combined with US demonstrated the best result in sensitivity (51.7 %) and negative predictive value (NPV) (88.1 %) compared to those of other imaging techniques. CT combined with US could improve sensitivity and NPV compared to CT or US alone. Considering cost-effectiveness and the highest results in all parameters compared to those of other combinations of imaging techniques, CT combined with US could be the best preoperative imaging modalities for evaluating laryngohypopharyngeal cancer. However, these imaging techniques are not absolutely reliable methods for detecting occult metastasis in the level VI due to high false-negative rates. Elective CCND should be considered in indicated patients (>N2b, T4), even if physical examinations and the radiologic findings of level VI nodes are negative.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, Korea.
authors.forename: Hae Sang
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Seoul National University, 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-Thyroid Cancer Hospital, College of Medicine, Hallym University, 445 Gil-dong, Kangdong-gu, Seoul, 134-701, Korea.
authors.forename: Min Woo
authors.initials: MW
authors.lastname: Park
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, Korea.
authors.forename: Sung Hee
authors.initials: SH
authors.lastname: Bae
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, EwhaWomans University, Seoul, Korea.
authors.forename: Soo Yeon
authors.initials: SY
authors.lastname: Jung
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, EwhaWomans University, Seoul, Korea.
authors.forename: Han Su
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Ilsong Memorial Head and Neck-Thyroid Cancer Hospital, College of Medicine, Hallym University, Seoul, Korea.
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Yoon
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Head and Neck-Thyroid Cancer Hospital, College of Medicine, Hallym University, 445 Gil-dong, Kangdong-gu, Seoul, 134-701, Korea. ys20805@chol.com.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Rho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Central compartment; Diagnostic imaging; Hypopharyngeal neoplasm; Laryngeal neoplasm; Lymphatic metastasis