Chung Eun-Jae, Kim Go-Woon, Cho Bum-Ki, Park Hae Sang, Rho Young-Soo
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Head and Neck Cancer Hospital, Hallym University, College of Medicine, Seoul, Korea.
Head Neck. 2016 Apr;38 Suppl 1:E1969-73. doi: 10.1002/hed.24361. Epub 2016 Feb 2.
The purpose of this study was to determine the incidence, risk factors, and prognostic significance of level VI lymph node metastases from hypopharyngeal squamous cell carcinoma (SCC).
A retrospective review of 68 previously untreated patients with hypopharyngeal SCC who underwent level VI node dissection was performed.
Level VI lymph node metastases occurred in 27.9% of patients. The occult metastasis rate of level VI node was 14.3%. Patients with level VI metastasis had significantly lower disease-specific (55.1% vs 26.3%) and overall survival rates (73.5% vs 31.6%). Level VI lymph node metastasis was significantly correlated with regional recurrence (83.7% vs 63.2%) and distant metastasis (67.3% vs 47.4%). Multivariate analysis revealed that pyriform sinus apex invasion (odds ratio [OR] = 5.106) was an independent factor for level VI nodal metastasis.
Level VI lymph nodes should be removed in patients with pyriform sinus apex invasion, especially in those with advanced nodal disease. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1969-E1973, 2016.
本研究旨在确定下咽鳞状细胞癌（SCC）Ⅵ区淋巴结转移的发生率、危险因素及预后意义。
对68例未经治疗且接受Ⅵ区淋巴结清扫术的下咽SCC患者进行回顾性分析。
27.9%的患者发生Ⅵ区淋巴结转移。Ⅵ区淋巴结隐匿转移率为14.3%。发生Ⅵ区转移的患者疾病特异性生存率（55.1%对26.3%）和总生存率（73.5%对31.6%）显著更低。Ⅵ区淋巴结转移与区域复发（83.7%对63.2%）和远处转移（67.3%对47.4%）显著相关。多因素分析显示梨状窝尖部侵犯（比值比[OR]=5.106）是Ⅵ区淋巴结转移的独立因素。
对于梨状窝尖部侵犯的患者，尤其是伴有晚期淋巴结疾病的患者，应切除Ⅵ区淋巴结。©2016威利期刊公司。《头颈》2016年第38卷：E1969 - E1973页。
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