Prediction of lymph-node metastasis and lymphatic invasion of superficial pharyngeal cancer on narrow band imaging with magnifying endoscopy.

OBJECTIVE

We studied factors related to lymphatic invasion and lymph-node metastasis in patients with superficial pharyngeal cancer who underwent transoral surgery.

METHODS

The study group comprised 67 patients with superficial pharyngeal cancer (92 lesions) in whom squamous cell carcinoma was histopathologically diagnosed. The primary endpoint was clinicopathological findings according to the presence or absence of lymph-node metastasis, lymphatic invasion, or both. The secondary endpoints were (1) endoscopic findings according to the presence or absence of subepithelial invasion and (2) tumor thickness according to the endoscopic findings.

RESULTS

Lymph-node metastasis, lymphatic invasion, or both were related to the white light findings of the main macroscopic type (p = 0.006), the NBI magnifying endoscopy findings of the classification of type B vessels (p = 0.005) and avascular area (AVA) (p = 0.003), and the histopathological findings of subepithelial invasion (p = 0.027), solitary nests (p = 0.013), venous invasion (p = 0.003), and tumor thickness (p = 0.028). The white light findings of white coat (p = 0.027), main macroscopic type (p = 0.005), and protruding type (p = 0.027) and the NBI magnifying endoscopy findings of the classification of type B vessels (p = 0.0002) were significantly related to subepithelial invasion. Tumor thickness was significantly related to the white light findings of white coat (p = 0.0002), main macroscopic type (p < 0.0001), protruding type (p < 0.0001), and mixed type (p = 0.017) and the NBI magnifying endoscopy findings of the classification of type B vessels (p < 0.0001) and AVA (p = 0.005).

CONCLUSION

Detailed assessment by means of NBI magnifying endoscopy at the time of transoral surgery may contribute to the prediction of lymphatic invasion and lymph-node metastasis in patients with superficial pharyngeal cancer.