Neck and mediastinal node dissection in pharyngolaryngeal tumors.

INTRODUCTION

The present study sought to determine the necessity and prognostic impact of superior mediastinum (SM) dissection in advanced upper aerodigestive tract squamous cell carcinoma (SCC).

METHODS

A retrospective review was made of the records of 31 patients who had undergone (pharyngo-) laryngectomy for advanced SCC. Statistical analysis examined correlations between the presence of SM lymph node metastasis and clinical factors, with a significance threshold of P<0.05.

RESULTS

Positive cervical and/or SM lymph nodes were found in 20 cases, including six with isolated positive SM nodes. Positive SM nodes were found in none of the patients with laryngeal SCC, versus six of the 13 patients with hypopharyngeal SCC, where they were associated with tumors greater than 35 mm. Presence of paratracheal lymph node metastasis showed a strong but not statistically significant association with the primary site (larynx vs. hypopharynx: P=0.08).

CONCLUSIONS

In the present series, advanced laryngeal carcinoma was never associated with positive SM nodes, whereas advanced hypopharyngeal carcinoma showed a trend in favor of paratracheal lymph node involvement.