Lefebvre J L, Castelain B, De la Torre J C, Delobelle-Deroide A, Vankemmel B
ENT and Head & Neck Oncology Department, Centre Oscar Lambret, Lille, France.
Head Neck Surg. 1987 Sep-Oct;10(1):14-8. doi: 10.1002/hed.2890100104.
Hypopharynx (HC: pyriform fossa, postcricoïd area, and posterior wall) and lateral epilarynx carcinomas (LEC: aryepiglottic fold, pharyngoepiglottic fold, and arytenoïd) have a high tendency to cervical lymph node invasion. Such nodal extension is a well-known prognostic factor. This study is based on a retrospective review of 884 clinical records of previously untreated HC or LEC. Seventy percent of patients revealed palpable nodes at their first examination, with a higher percentage for HC (73%) than LEC (62%). The 5-year survival rate was divided by three in the presence of contralateral, bilateral, or fixed nodes, or in cases of nodes exceeding 3 cm. Multiple positive nodes, extracapsular spread, or lower-neck positive nodes significantly decreased survival, doubled the number of neck recurrences, and tripled the number of distant metastases while control at the primary site remained unvaried.
下咽（HC：梨状窝、环状软骨后区和后壁）及喉外侧癌（LEC：杓会厌襞、咽会厌襞和杓状软骨）极易发生颈部淋巴结转移。这种淋巴结转移是一个众所周知的预后因素。本研究基于对884例未经治疗的HC或LEC患者临床记录的回顾性分析。70%的患者在首次检查时可触及肿大淋巴结，其中HC患者的比例（73%）高于LEC患者（62%）。若存在对侧、双侧或固定淋巴结，或淋巴结直径超过3 cm，5年生存率会降低三分之二。多个阳性淋巴结、包膜外扩散或下颈部阳性淋巴结会显著降低生存率，使颈部复发次数增加一倍，远处转移次数增加两倍，而原发部位的控制情况保持不变。
