Tumor depth as a predictor of lymph node metastasis of supraglottic and hypopharyngeal cancers

Masayuki Tomifuji, Yorihisa Imanishi, Koji Araki, Taku Yamashita, Sohei Yamamoto, Kaori Kameyama, Akihiro Shiotani

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background: The relationship between the histological parameters of primary lesions and lymph node metastasis in supraglottic and hypopharyngeal cancers has not been elucidated. This analysis is important to evaluate the requirement for additional elective neck dissection when clinically node-negative cancers are treated by transoral surgery. Methods: This study included 40 previously untreated patients with supraglottic and hypopharyngeal cancers who underwent transoral en bloc tumor resection in two academic tertiary referral centers. Nodal status was confirmed by neck dissection for cases with findings or suspicion of lymph node metastases or by observation of clinically node-negative cases for more than 1 year. Patients' medical records and pathological features were analyzed retrospectively. The correlation of histological parameters with lymph node metastases, including occult metastases, was evaluated by univariate and multiple logistic regression analyses. Results: Univariate analysis showed that lymph node metastasis was correlated with tumor depth (P = 0.00087) and venous invasion (P = 0.027). Multiple logistic regression analysis showed that it was significantly correlated only with tumor depth (P = 0.007). Conclusions: Tumor depth is the most useful parameter for predicting lymph node metastases. In clinically node-negative cases, when tumor depth exceeds 1 mm, elective neck dissection must be considered and, when it is less than 0.5 mm, regular clinical follow-up is recommended. Patients with tumor depth between 0.5 and 1 mm should be carefully observed, since they also have a chance of developing nodal metastasis. Venous invasion also indicates high rates of nodal metastasis, therefore elective neck dissection must be considered for these cases.

Original languageEnglish
Pages (from-to)490-496
Number of pages7
JournalAnnals of Surgical Oncology
Volume18
Issue number2
DOIs
Publication statusPublished - 2011 Feb

Fingerprint

Hypopharyngeal Neoplasms
Lymph Nodes
Neoplasm Metastasis
Neck Dissection
Neoplasms
Logistic Models
Regression Analysis
Tertiary Care Centers
Medical Records
Observation

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Tumor depth as a predictor of lymph node metastasis of supraglottic and hypopharyngeal cancers. / Tomifuji, Masayuki; Imanishi, Yorihisa; Araki, Koji; Yamashita, Taku; Yamamoto, Sohei; Kameyama, Kaori; Shiotani, Akihiro.

In: Annals of Surgical Oncology, Vol. 18, No. 2, 02.2011, p. 490-496.

Research output: Contribution to journalArticle

Tomifuji, M, Imanishi, Y, Araki, K, Yamashita, T, Yamamoto, S, Kameyama, K & Shiotani, A 2011, 'Tumor depth as a predictor of lymph node metastasis of supraglottic and hypopharyngeal cancers', Annals of Surgical Oncology, vol. 18, no. 2, pp. 490-496. https://doi.org/10.1245/s10434-010-1219-5
Tomifuji, Masayuki ; Imanishi, Yorihisa ; Araki, Koji ; Yamashita, Taku ; Yamamoto, Sohei ; Kameyama, Kaori ; Shiotani, Akihiro. / Tumor depth as a predictor of lymph node metastasis of supraglottic and hypopharyngeal cancers. In: Annals of Surgical Oncology. 2011 ; Vol. 18, No. 2. pp. 490-496.
@article{7ff2dc2b10024f8b896820283144c716,
title = "Tumor depth as a predictor of lymph node metastasis of supraglottic and hypopharyngeal cancers",
abstract = "Background: The relationship between the histological parameters of primary lesions and lymph node metastasis in supraglottic and hypopharyngeal cancers has not been elucidated. This analysis is important to evaluate the requirement for additional elective neck dissection when clinically node-negative cancers are treated by transoral surgery. Methods: This study included 40 previously untreated patients with supraglottic and hypopharyngeal cancers who underwent transoral en bloc tumor resection in two academic tertiary referral centers. Nodal status was confirmed by neck dissection for cases with findings or suspicion of lymph node metastases or by observation of clinically node-negative cases for more than 1 year. Patients' medical records and pathological features were analyzed retrospectively. The correlation of histological parameters with lymph node metastases, including occult metastases, was evaluated by univariate and multiple logistic regression analyses. Results: Univariate analysis showed that lymph node metastasis was correlated with tumor depth (P = 0.00087) and venous invasion (P = 0.027). Multiple logistic regression analysis showed that it was significantly correlated only with tumor depth (P = 0.007). Conclusions: Tumor depth is the most useful parameter for predicting lymph node metastases. In clinically node-negative cases, when tumor depth exceeds 1 mm, elective neck dissection must be considered and, when it is less than 0.5 mm, regular clinical follow-up is recommended. Patients with tumor depth between 0.5 and 1 mm should be carefully observed, since they also have a chance of developing nodal metastasis. Venous invasion also indicates high rates of nodal metastasis, therefore elective neck dissection must be considered for these cases.",
author = "Masayuki Tomifuji and Yorihisa Imanishi and Koji Araki and Taku Yamashita and Sohei Yamamoto and Kaori Kameyama and Akihiro Shiotani",
year = "2011",
month = "2",
doi = "10.1245/s10434-010-1219-5",
language = "English",
volume = "18",
pages = "490--496",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - Tumor depth as a predictor of lymph node metastasis of supraglottic and hypopharyngeal cancers

AU - Tomifuji, Masayuki

AU - Imanishi, Yorihisa

AU - Araki, Koji

AU - Yamashita, Taku

AU - Yamamoto, Sohei

AU - Kameyama, Kaori

AU - Shiotani, Akihiro

PY - 2011/2

Y1 - 2011/2

N2 - Background: The relationship between the histological parameters of primary lesions and lymph node metastasis in supraglottic and hypopharyngeal cancers has not been elucidated. This analysis is important to evaluate the requirement for additional elective neck dissection when clinically node-negative cancers are treated by transoral surgery. Methods: This study included 40 previously untreated patients with supraglottic and hypopharyngeal cancers who underwent transoral en bloc tumor resection in two academic tertiary referral centers. Nodal status was confirmed by neck dissection for cases with findings or suspicion of lymph node metastases or by observation of clinically node-negative cases for more than 1 year. Patients' medical records and pathological features were analyzed retrospectively. The correlation of histological parameters with lymph node metastases, including occult metastases, was evaluated by univariate and multiple logistic regression analyses. Results: Univariate analysis showed that lymph node metastasis was correlated with tumor depth (P = 0.00087) and venous invasion (P = 0.027). Multiple logistic regression analysis showed that it was significantly correlated only with tumor depth (P = 0.007). Conclusions: Tumor depth is the most useful parameter for predicting lymph node metastases. In clinically node-negative cases, when tumor depth exceeds 1 mm, elective neck dissection must be considered and, when it is less than 0.5 mm, regular clinical follow-up is recommended. Patients with tumor depth between 0.5 and 1 mm should be carefully observed, since they also have a chance of developing nodal metastasis. Venous invasion also indicates high rates of nodal metastasis, therefore elective neck dissection must be considered for these cases.

AB - Background: The relationship between the histological parameters of primary lesions and lymph node metastasis in supraglottic and hypopharyngeal cancers has not been elucidated. This analysis is important to evaluate the requirement for additional elective neck dissection when clinically node-negative cancers are treated by transoral surgery. Methods: This study included 40 previously untreated patients with supraglottic and hypopharyngeal cancers who underwent transoral en bloc tumor resection in two academic tertiary referral centers. Nodal status was confirmed by neck dissection for cases with findings or suspicion of lymph node metastases or by observation of clinically node-negative cases for more than 1 year. Patients' medical records and pathological features were analyzed retrospectively. The correlation of histological parameters with lymph node metastases, including occult metastases, was evaluated by univariate and multiple logistic regression analyses. Results: Univariate analysis showed that lymph node metastasis was correlated with tumor depth (P = 0.00087) and venous invasion (P = 0.027). Multiple logistic regression analysis showed that it was significantly correlated only with tumor depth (P = 0.007). Conclusions: Tumor depth is the most useful parameter for predicting lymph node metastases. In clinically node-negative cases, when tumor depth exceeds 1 mm, elective neck dissection must be considered and, when it is less than 0.5 mm, regular clinical follow-up is recommended. Patients with tumor depth between 0.5 and 1 mm should be carefully observed, since they also have a chance of developing nodal metastasis. Venous invasion also indicates high rates of nodal metastasis, therefore elective neck dissection must be considered for these cases.

UR - http://www.scopus.com/inward/record.url?scp=79951552511&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79951552511&partnerID=8YFLogxK

U2 - 10.1245/s10434-010-1219-5

DO - 10.1245/s10434-010-1219-5

M3 - Article

VL - 18

SP - 490

EP - 496

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 2

ER -