Sao Paulo Federal University, Sao Paulo, Brazil.
Braz J Otorhinolaryngol. 2009 Jul-Aug;75(4):493-6. doi: 10.1016/s1808-8694(15)30485-7.
Lymph node metastases (LNM) are common in hypophariyngeal carcinomas; the neck dissection is an important therapeutic approach.
to analyze the incidence and distribution of LNM and failures in treating the contralateral neck.
a retrospective study of 174 patients with hypopharyngeal cancer treated from 1978 to 2003. The distribution of LNM and regional recurrences were evaluated.
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).
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.
分析下咽癌颈部淋巴结转移（LNM）的发生率和分布，以及对侧颈部治疗失败的原因。
回顾性分析 1978 年至 2003 年间收治的 174 例下咽癌患者的临床资料。评估 LNM 和区域性复发的分布情况。
44%的病例为假阴性，4.9%为假阳性。在 48 例行双侧颈清扫术（ND）的患者中，29 例为双侧转移，1 例为对侧转移。行单侧 ND 的 12 例患者出现对侧颈部复发。9 例仅对侧颈部复发的患者中，8 例经手术挽救。对侧转移的风险与临床分期（p=0.003）和梨状窝内侧壁受累（p=0.03）有关，而与放疗无关（p=0.28）。
当梨状窝内侧壁受累、同侧可触及转移和临床分期为 IV 期时，更常发生对侧转移。
