Impact of cervical lymph node metastasis on transoral surgery for hypopharyngeal squamous cell carcinoma: A retrospective multicenter study

Head Neck. 2024 Aug;46(8):1913-1921. doi: 10.1002/hed.27666. Epub 2024 Jan 31.

Abstract

Background: Hypopharyngeal carcinoma is likely to spread to the lymph nodes, but there is no established strategy for management in transoral surgery.

Methods: We compared oncologic and functional outcomes in a retrospective multicenter study of patients who underwent transoral surgery for hypopharyngeal carcinoma between 2015 and 2021.

Results: Two-hundred and thirty-two patients were included. Comparing patients with and without adjuvant radiotherapy, 3-year regional recurrence-free survival (RRFS) was not significantly different in pN2b and pN2c, but was significantly worse in pN3b without adjuvant radiotherapy. In patients without neck dissection, the 3-year RRFS was 85.6%, 76.8%, and 70.0% for T1, T2, and T3 primary lesions, respectively, and was significantly worse for T2 or higher (p = 0.035).

Conclusions: In the absence of extracapsular invasion, regional control did not deteriorate without adjuvant therapy. If prophylactic neck dissection is not performed, careful follow-up is necessary if the primary lesion is T2 or greater.

Keywords: adjuvant therapy; cervical lymph node metastasis; hypopharyngeal cancer; multi‐institutional retrospective study; transoral surgery.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Carcinoma, Squamous Cell / therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Hypopharyngeal Neoplasms* / mortality
  • Hypopharyngeal Neoplasms* / pathology
  • Hypopharyngeal Neoplasms* / surgery
  • Hypopharyngeal Neoplasms* / therapy
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis*
  • Male
  • Middle Aged
  • Natural Orifice Endoscopic Surgery / methods
  • Neck Dissection*
  • Neoplasm Staging
  • Radiotherapy, Adjuvant
  • Retrospective Studies