Murakami Y, Ikari T, Haraguchi S, Okada K, Maruyama T, Saito S
Auris Nasus Larynx. 1985;12 Suppl 2:S36-40. doi: 10.1016/s0385-8146(85)80025-0.
Margins of extirpated specimens of hypopharyngeal cancer were examined histopathologically. Residual cancer nest, which is most likely due to directional preponderance of the submucosal lymph flow of the hypopharyngeal cavity, was characteristically demonstrated at the superior margin and in the submucosal layer. We propose that laryngopharyngectomy be done at the extended excision level superiorly at the base of the palatine tonsil and inferiorly at the level of the 2nd thoracic vertebra and with a safety margin of at least 2 cm. The incidence of ipsilateral and contralateral neck metastasis was also histopathologically evaluated from specimens obtained by neck dissection. Contralateral neck metastasis was histopathologically confirmed in more than 30% of the cases examined and showed a difference in incidence related to histological differentiation and T classification. We conclude that bilateral neck dissection is advisable in all cases of hypopharyngeal cancer except for patients with a well-differentiated T2 lesion.
对下咽癌切除标本的边缘进行了组织病理学检查。残留癌巢，最有可能是由于下咽腔黏膜下淋巴引流的方向性优势，其特征性地出现在上缘和黏膜下层。我们建议在腭扁桃体基部上方和第二胸椎水平下方进行扩大切除水平的喉咽切除术，安全切缘至少为2厘米。还从颈部清扫获得的标本中对同侧和对侧颈部转移的发生率进行了组织病理学评估。在超过30%的检查病例中组织病理学证实了对侧颈部转移，并且显示出与组织学分化和T分类相关的发生率差异。我们得出结论，除了高分化T2病变患者外，所有下咽癌病例均建议进行双侧颈部清扫。
