Article

Distribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts

Department of Radiotherapy, The University of Texas at Houston M. D. Anderson Hospital and Tumor Institute, Houston, Tex.
Cancer (Impact Factor: 5.2). 05/1972; 29(6):1446 - 1449. DOI: 10.1002/1097-0142(197206)29:6<1446::AID-CNCR2820290604>3.0.CO;2-C

ABSTRACT The records of 2,044 patients with previously untreated squamous cell carcinomas of the head and neck were reviewed in order to define the incidence and topographical distribution of lymph node metastasis on admission. The common regions of metastasis are presented for each of the seven individual head and neck sites selected for study. Knowledge of the preferred areas of spread and those that are almost never involved allows the design of more adequate plans to manage the individual lesions.

0 Bookmarks
 · 
64 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Wenn bei Auftreten von Lymphknotenmetastasen die Primärtumorlokalisation durch die initialen diagnostischen Schritte verborgen bleibt, spricht man von „cancer of unknown primary“ (CUP-Syndrom). Diese Manifestationsform betrifft 4–5% aller humanen Malignome und liegt damit unter den 10 häufigsten Krebsarten. Wenn der Primärtumor durch erweiterte Diagnostik schließlich detektiert wird, liegt ein initiales CUP-Syndrom vor, sonst spricht man von einem echten CUP-Syndrom. Die häufigsten CUP-Metastasen sind Adenokarzinome, gefolgt von schlecht differenzierten Karzinomen, Plattenepithelkarzinomen und neuroendokrinen Tumoren. Halslymphknotenmetastasen unbekannten Ursprungs haben generell eine schlechtere Prognose als die meisten Kopf-Hals-Tumoren, was aber von einer Reihe von Einflussfaktoren abhängt. Dieser Beitrag stellt moderne diagnostische Schritte wie PET-CT/MRT vor und erörtert die therapeutischen Optionen und die Prognose der Patienten mit einem zervikalen CUP-Syndrom.
    Der Onkologe 01/2013; 19(1). · 0.13 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Squamous cell carcinoma of the oropharynx (OPSCC) occurs with an age-adjusted incidence rate of 2.2/100,000 per year, and makes up one of the largest growing subsets of head and neck cancer. Traditional risk factors include alcohol and tobacco exposure, however, the demographics have changed significantly over the past 2–3 decades, with human papillomavirus (HPV) infection now considered one of the most important risk factors. As our understanding of HPV-related OPSCC has developed, there has been increasing evidence that this new tumor subtype has a better overall prognosis and response to therapies. This review focuses on OPSCC from a surgical perspective. We review the relevant anatomy, diagnosis and workup, and discuss several different surgical approaches for management of this disease, including transoral robotic surgery, lateral oropharyngectomy and tonsillectomy, base of tongue resection, and neck dissection. In addition, the common complications associated with these treatment options are discussed.
    Current Otorhinolaryngology Reports. 1(3).
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background. To assess the risk of subclinical neck nodal involvement of levels IB, IV and V for early T-stage, node positive, human papilloma virus (HPV)-related oropharyngeal carcinoma. Material and methods. We retrospectively identified the patients with clinically positive and un-violated neck that underwent upfront ipsilateral neck dissection for HPV-related oropharyngeal cancer between 1998 and 2010. From the pathology report we extracted the prevalence rate of involvement of each selected level and then estimated the risk that a level that does not contain any node larger than 10 mm at computed tomography (CT) harbors subclinical disease. Predictors of involvement were investigated as well. Results. Ninety-one patients were analyzed. The risk of subclinical disease in both levels IB and V is < 5%, while it is 6.5% (95% CI 3.1-9.9%) for level IV. Level IB subclinical involvement slightly exceeds 5% when 2 + ipsilateral levels besides IB are involved. The risk of occult disease in level IV tends to be < 5% when level III is not involved. Conclusion. These data support the exclusion from the elective nodal volume of level V and level IB but when 2 + other levels are involved. Level IV might also be spared when level III is negative. Clinical implementation within a prospective study is justified.
    Acta oncologica (Stockholm, Sweden) 11/2013; · 2.27 Impact Factor

Full-text

Download
0 Downloads