Indication of elective contralateral neck dissection in squamous cell carcinoma of the hypopharynx

Detalhes bibliográficos
Autor(a) principal: Amar, Ali [UNIFESP]
Data de Publicação: 2009
Outros Autores: Dedivitis, Rogério Aparecido [UNIFESP], Rapoport, Abrão [UNIFESP], Quarteiro, André Luiz
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.1590/S1808-86942009000400004
http://repositorio.unifesp.br/handle/11600/5137
Resumo: Lymph node metastases (LNM) are common in hypophariyngeal carcinomas; the neck dissection is an important therapeutic approach. AIM: to analyze the incidence and distribution of LNM and failures in treating the contralateral neck. METHODS: a retrospective study of 174 patients with hypopharyngeal cancer treated from 1978 to 2003. The distribution of LNM and regional recurrences were evaluated. RESULTS: 44% of the cases were false negatives and 4.9% were false positives. Among the 48 patients who underwent bilateral ND, 29 had bilateral metastases and one had contralateral metastasis. Contralateral neck recurrences occurred in 12 cases that underwent unilateral ND. Among the nine patients with contralateral neck recurrence alone, eight were surgically salvaged. The risk of contralateral metastases was related to clinical staging (p=0.003) and involvement of the medial wall of the pyriform sinus (p=0.03), but not to radiotherapy (p=0.28). CONCLUSION: Contralateral metastases were more frequent when the medial wall of the pyriform sinus was affected, in the presence of ipsilateral palpable metastases and clinical stage IV.
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spelling Indication of elective contralateral neck dissection in squamous cell carcinoma of the hypopharynxIndicação do esvaziamento eletivo contralateral no carcinoma espinocelular da hipofaringesquamous cell carcinomaneck dissectionhypopharynxlymphatic metastasiscarcinoma de células escamosasesvaziamento cervicalhipofaringemetástase linfáticaLymph node metastases (LNM) are common in hypophariyngeal carcinomas; the neck dissection is an important therapeutic approach. AIM: to analyze the incidence and distribution of LNM and failures in treating the contralateral neck. METHODS: a retrospective study of 174 patients with hypopharyngeal cancer treated from 1978 to 2003. The distribution of LNM and regional recurrences were evaluated. RESULTS: 44% of the cases were false negatives and 4.9% were false positives. Among the 48 patients who underwent bilateral ND, 29 had bilateral metastases and one had contralateral metastasis. Contralateral neck recurrences occurred in 12 cases that underwent unilateral ND. Among the nine patients with contralateral neck recurrence alone, eight were surgically salvaged. The risk of contralateral metastases was related to clinical staging (p=0.003) and involvement of the medial wall of the pyriform sinus (p=0.03), but not to radiotherapy (p=0.28). CONCLUSION: Contralateral metastases were more frequent when the medial wall of the pyriform sinus was affected, in the presence of ipsilateral palpable metastases and clinical stage IV.As metástases linfonodais são frequentes nos carcinomas da hipofaringe e o esvaziamento cervical é parte importante do tratamento. OBJETIVO: Avaliar a incidência e distribuição das metástases linfonodais e as falhas no tratamento do pescoço contralateral. MÉTODOS: Estudo retrospectivo de 174 pacientes com carcinoma epidermoide de hipofaringe tratados entre 1978 e 2003. Foi avaliada a distribuição das metástases linfonodais e as recidivas regionais. RESULTADOS: Foram diagnosticados 44% de casos falso-negativos e 4,9% falso-positivos. Dos 48 pacientes submetidos ao esvaziamento bilateral, 29 apresentaram metástases bilaterais e um apresentou metástase contralateral apenas. As recidivas cervicais contralaterais ocorreram em 12 casos submetidos ao esvaziamento unilateral. Dos 9 pacientes com recidiva cervical contralateral isolada, 8 pacientes foram resgatados cirurgicamente. O risco de metástases contralaterais relacionou-se com o estadiamento clínico (p=0,003) e com o comprometimento da parede medial do recesso piriforme (p=0,03), mas não com a realização de radioterapia (p=0,28). CONCLUSÕES: As metástases contralaterais nos carcinomas da hipofaringe foram mais frequentes quando a parede medial do recesso piriforme estava comprometida, na presença de metástases palpáveis ipsilaterais e estádio clínico IV.Heliopolis HospitalUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) course in otorhinolaryngology and head & neck surgeryHeliopolis Hospital Escola Paulista de Medicina course in otorhinolaryngology and head & neck surgeryUNIFESP, EPM, course in otorhinolaryngology and head & neck surgeryHeliopolis Hospital Escola Paulista de Medicina course in otorhinolaryngology and head & neck surgerySciELOAssociação Brasileira de Otorrinolaringologia e Cirurgia CervicofacialHeliopolis HospitalUniversidade Federal de São Paulo (UNIFESP)Amar, Ali [UNIFESP]Dedivitis, Rogério Aparecido [UNIFESP]Rapoport, Abrão [UNIFESP]Quarteiro, André Luiz2015-06-14T13:41:01Z2015-06-14T13:41:01Z2009-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion493-496application/pdfhttp://dx.doi.org/10.1590/S1808-86942009000400004Brazilian Journal of Otorhinolaryngology. Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, v. 75, n. 4, p. 493-496, 2009.10.1590/S1808-86942009000400004S1808-86942009000400004.pdf1808-8694S1808-86942009000400004http://repositorio.unifesp.br/handle/11600/5137engBrazilian Journal of Otorhinolaryngologyinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-06T10:11:51Zoai:repositorio.unifesp.br/:11600/5137Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-06T10:11:51Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Indication of elective contralateral neck dissection in squamous cell carcinoma of the hypopharynx
Indicação do esvaziamento eletivo contralateral no carcinoma espinocelular da hipofaringe
title Indication of elective contralateral neck dissection in squamous cell carcinoma of the hypopharynx
spellingShingle Indication of elective contralateral neck dissection in squamous cell carcinoma of the hypopharynx
Amar, Ali [UNIFESP]
squamous cell carcinoma
neck dissection
hypopharynx
lymphatic metastasis
carcinoma de células escamosas
esvaziamento cervical
hipofaringe
metástase linfática
title_short Indication of elective contralateral neck dissection in squamous cell carcinoma of the hypopharynx
title_full Indication of elective contralateral neck dissection in squamous cell carcinoma of the hypopharynx
title_fullStr Indication of elective contralateral neck dissection in squamous cell carcinoma of the hypopharynx
title_full_unstemmed Indication of elective contralateral neck dissection in squamous cell carcinoma of the hypopharynx
title_sort Indication of elective contralateral neck dissection in squamous cell carcinoma of the hypopharynx
author Amar, Ali [UNIFESP]
author_facet Amar, Ali [UNIFESP]
Dedivitis, Rogério Aparecido [UNIFESP]
Rapoport, Abrão [UNIFESP]
Quarteiro, André Luiz
author_role author
author2 Dedivitis, Rogério Aparecido [UNIFESP]
Rapoport, Abrão [UNIFESP]
Quarteiro, André Luiz
author2_role author
author
author
dc.contributor.none.fl_str_mv Heliopolis Hospital
Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Amar, Ali [UNIFESP]
Dedivitis, Rogério Aparecido [UNIFESP]
Rapoport, Abrão [UNIFESP]
Quarteiro, André Luiz
dc.subject.por.fl_str_mv squamous cell carcinoma
neck dissection
hypopharynx
lymphatic metastasis
carcinoma de células escamosas
esvaziamento cervical
hipofaringe
metástase linfática
topic squamous cell carcinoma
neck dissection
hypopharynx
lymphatic metastasis
carcinoma de células escamosas
esvaziamento cervical
hipofaringe
metástase linfática
description Lymph node metastases (LNM) are common in hypophariyngeal carcinomas; the neck dissection is an important therapeutic approach. AIM: to analyze the incidence and distribution of LNM and failures in treating the contralateral neck. METHODS: a retrospective study of 174 patients with hypopharyngeal cancer treated from 1978 to 2003. The distribution of LNM and regional recurrences were evaluated. RESULTS: 44% of the cases were false negatives and 4.9% were false positives. Among the 48 patients who underwent bilateral ND, 29 had bilateral metastases and one had contralateral metastasis. Contralateral neck recurrences occurred in 12 cases that underwent unilateral ND. Among the nine patients with contralateral neck recurrence alone, eight were surgically salvaged. The risk of contralateral metastases was related to clinical staging (p=0.003) and involvement of the medial wall of the pyriform sinus (p=0.03), but not to radiotherapy (p=0.28). CONCLUSION: Contralateral metastases were more frequent when the medial wall of the pyriform sinus was affected, in the presence of ipsilateral palpable metastases and clinical stage IV.
publishDate 2009
dc.date.none.fl_str_mv 2009-08-01
2015-06-14T13:41:01Z
2015-06-14T13:41:01Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/S1808-86942009000400004
Brazilian Journal of Otorhinolaryngology. Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, v. 75, n. 4, p. 493-496, 2009.
10.1590/S1808-86942009000400004
S1808-86942009000400004.pdf
1808-8694
S1808-86942009000400004
http://repositorio.unifesp.br/handle/11600/5137
url http://dx.doi.org/10.1590/S1808-86942009000400004
http://repositorio.unifesp.br/handle/11600/5137
identifier_str_mv Brazilian Journal of Otorhinolaryngology. Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, v. 75, n. 4, p. 493-496, 2009.
10.1590/S1808-86942009000400004
S1808-86942009000400004.pdf
1808-8694
S1808-86942009000400004
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Brazilian Journal of Otorhinolaryngology
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 493-496
application/pdf
dc.publisher.none.fl_str_mv Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial
publisher.none.fl_str_mv Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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