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Pang W, Luo Y, Li J, Cheng D, Rao Y, Mao M, Qiu K, Dong Y, Liu J, Zou J, Wang H, Chen F. The Prognostic Prediction Value of Positive Lymph Nodes Numbers for the Hypopharyngeal Squamous Cell Carcinoma. Front Med (Lausanne) 2022; 9:898483. [PMID: 35860727 PMCID: PMC9291443 DOI: 10.3389/fmed.2022.898483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe current American Joint Committee on Cancer (AJCC) system only considered the importance of the size and laterality of lymph nodes while not the positive lymph node number (PLNN) for hypopharyngeal squamous cell carcinoma (HPSCC).MethodsA total of 973 patients with HPSCC from the Surveillance, Epidemiology, and End Results database (2004–2015) were identified. Univariate and multivariate Cox regression analyses were used to evaluate the prognostic effects. We applied six Cox regression models to compare the survival prognostic values of PLNN and AJCC systems.ResultsPositive lymph node number showed a significant association with overall survival (OS) and cancer-specific survival (CSS) (P < 0.001) in univariate and multivariable analyses. The increased PLNN of HPSCC gave rise to poor OS and CSS. The survival model incorporating a composite of PLNN and TNM classification (C-index for OS:0.682, C-index for CSS:0.702) performed better than other models.ConclusionsA positive lymph node number could serve as a survival predictor for patients with HPSCC and a complement to enhance the prognostic assessment effects of TNM cancer staging systems.
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Affiliation(s)
- Wendu Pang
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yaxin Luo
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Junhong Li
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Danni Cheng
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yufang Rao
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Minzi Mao
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ke Qiu
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yijun Dong
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Liu
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Zou
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Haiyang Wang
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
- Haiyang Wang
| | - Fei Chen
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Fei Chen
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Wang D, Zhang S, Xu J, Zhai L, Li B. Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging. PRECISION RADIATION ONCOLOGY 2021. [DOI: 10.1002/pro6.1137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Dongqing Wang
- Department of Radiation Oncology for Head and Neck Cancer Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan China
- Tianjin Medical University Tianjin China
| | - Shuguang Zhang
- Department of Surgical Oncology for Head and Neck Cancer Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan China
| | - Jin Xu
- Department of Radiation Oncology for Head and Neck Cancer Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan China
| | - Limin Zhai
- Department of Radiation Oncology for Head and Neck Cancer Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan China
| | - Baosheng Li
- Department of Radiation Oncology for Head and Neck Cancer Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan China
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Patterns of regional lymph node failure of locally advanced hypopharyngeal squamous cell carcinoma after first-line treatment with surgery and/or intensity-modulated radiotherapy. BMC Cancer 2020; 20:283. [PMID: 32252691 PMCID: PMC7137435 DOI: 10.1186/s12885-020-06793-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 03/26/2020] [Indexed: 01/04/2023] Open
Abstract
Background To identify the spatial patterns of regional lymph node failure of locally advanced hypopharyngeal squamous cell carcinoma (SCC) after first-line treatment with surgery and/or intensity-modulated radiotherapy (IMRT). Methods We retrospectively obtained the clinicopathological characters of 123 hypopharyngeal SCC patients, and investigated the patterns of regional lymph node failure. Univariate and multivariate logistic regression were used to determine the risk factors of regional lymph node failure. Results Forty patients (32.5% of total patients) were suffered regional lymph node failure. In these patients, the ipsilateral neck level II nodal failure account for 55.0% (22/40) followed by level III 30.0% (12/40), level VIb 15.0% (6/40), level VII 15.0% (6/40), and level IV 5.0% (2/40). In addition, 17.5% (7/40) patients suffered contralateral neck level II nodal failure and 7.5% (3/40) patients suffered level III nodal failure. The common failure levels were the II (7/46, 15.2%), III (4/46, 8.7%), VIb (4/46, 8.7%), and VII (5/46, 10.9%) for treatment by surgery. The lymph node recurrence and persistent disease at levels II (19/77, 24.7%) and III (10/77, 13.0%) remained the major cause of failure following curative intent of IMRT. The postoperative radiation significantly decreased the risk of regional lymph node failure (OR = 0.082, 95% CI: 0.007–1.000, P = 0.049); and the radiologic extranodal extension significantly increased the risk of regional lymph node failure (OR = 11.07, 95% CI: 2.870–42.69, P < 0.001). Conclusions Whatever the treatment modality, the lymph node failure at level II and III was the most popular pattern for hypopharyngeal SCC. Moreover, for patients who underwent surgery, the nodal failure at level VIb and VII was frequent. Thus, postoperative radiation of level VIb and VII may give rise to benefit to locally advanced hypopharyngeal SCC patients.
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Diagnostic ability of [18F]-fluorodeoxyglucose-positron emission tomography/computed tomography for retropharyngeal lymph node in patients with oral cancer. Nucl Med Commun 2019; 40:1036-1042. [PMID: 31365495 DOI: 10.1097/mnm.0000000000001071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The first aim of this study was to evaluate the diagnostic ability of [F]-fluorodeoxyglucose-PET/computed tomography (FDG-PET/CT) for retropharyngeal lymph node (RPLN) metastasis in patients with oral cancer. The second was to compare this with those of CT and MRI. METHODS Among patients examined by both FDG-PET/CT and morphological imaging such as CT and MRI within 1 month, 42 patients (24 males and 18 females, mean age: 63.5 years; age range: 26-94 years) with a final diagnosis of retropharyngeal lymph node were included in this study. The diagnostic abilities for RPLN metastasis were evaluated by maximum standardized uptake value on PET/CT images and short axis diameter on morphological images. Optimal cut-off values for the nodal diagnoses of these modalities were obtained by receiver operating characteristic (ROC) analysis. RESULTS In the ROC analysis, PET/CT had the largest area under the curve (AUC = 0.903), and diagnostic ability was superior to morphological images such as CT (0.678) and MRI (0.707). Using a maximum standardized uptake value of 3.5 as the cut-off value, sensitivity of 83.3%, specificity of 100% and accuracy of 95.2% were obtained. CONCLUSION The diagnostic ability of FDG-PET/CT for RPLN metastasis was superior to CT and MRI. FDG-PET/CT is considered a useful tool for the diagnosis of RPLN in patients with oral cancer.
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Pollard C, Nguyen TP, Ng SP, Frank SJ, Garden AS, Gunn GB, Fuller CD, Beadle BM, Morrison WH, Shah SJ, Wang H, Tung S, Wang C, Ginsberg LD, Zafereo ME, Sturgis EM, Su SY, Hanna EY, Rosenthal DI, Phan J. Clinical outcomes after local field conformal reirradiation of patients with retropharyngeal nodal metastasis. Head Neck 2017; 39:2079-2087. [PMID: 28741749 DOI: 10.1002/hed.24872] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/11/2017] [Accepted: 05/29/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The purpose of this study was to present our experience with retropharyngeal node reirradiation using highly conformal radiotherapy (RT). METHODS A retrospective screen of 2504 consecutively irradiated patients with head and neck malignancies between 2005 and 2015 identified 19 patients who underwent reirradiation for retropharyngeal node metastasis. Clinical and toxicity outcomes were assessed in these patients. RESULTS Thirteen patients (68%) had squamous cell carcinoma. Eleven patients (58%) received conventionally fractionated intensity-modulated radiotherapy (IMRT) or proton therapy, and 8 patients (42%) received single-fractionated or hypofractionated stereotactic RT. Fourteen patients (74%) received chemotherapy. Median follow-up was 14.7 months. The 1-year local control, locoregional control, overall survival, and progression-free survival rates were 100%, 94%, 92%, and 92%, respectively. Three patients (16%) experienced acute grade 3 toxicity and occurred in those treated with IMRT. There was no late grade ≥3 toxicity. CONCLUSION Retropharyngeal node reirradiation with conformal therapy is well tolerated and associated with excellent short-term disease control.
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Affiliation(s)
- Courtney Pollard
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Theresa P Nguyen
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sweet Ping Ng
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Steven J Frank
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adam S Garden
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gary B Gunn
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Clifton D Fuller
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Beth M Beadle
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - William H Morrison
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shah J Shah
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - He Wang
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sam Tung
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Conjun Wang
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lawrence D Ginsberg
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark E Zafereo
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Erich M Sturgis
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shirley Y Su
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David I Rosenthal
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jack Phan
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
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Gangl K, Nemec S, Altorjai G, Pammer J, Grasl MC, Erovic BM. Prognostic survival value of retropharyngeal lymph node involvement in sinonasal tumors: A retrospective, descriptive, and exploratory study. Head Neck 2017; 39:1421-1427. [PMID: 28452184 DOI: 10.1002/hed.24782] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 10/26/2016] [Accepted: 02/10/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Sinonasal carcinomas are rare. The purpose of this study was for us to present our assessment of the effects of retropharyngeal lymph node involvement at diagnosis on patient outcomes. METHODS Retropharyngeal lymph node involvement in 36 patients with sinonasal carcinoma was determined by radiology at initial presentation. Clinical outcome, in particular, overall survival (OS) and locoregional control, was assessed by Kaplan-Meier analysis and log-rank testing. RESULTS Retropharyngeal lymph node involvement was associated with statistically significant decreased OS (P = .0066) in the patient collective. In the squamous cell carcinoma (SCC) subgroup (n = 23), decreased OS (P = .0046) and worse locoregional control (P = .0065) were observed. In these patients, decreased OS (P = .0423) and worse locoregional control (P = .0315) were also seen in the advanced tumor subgroup. CONCLUSION Retropharyngeal lymph node involvement at diagnosis is a significant prognostic factor for decreased OS and locoregional control in sinonasal carcinoma.
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Affiliation(s)
- Katharina Gangl
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Stefan Nemec
- Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - Gabriela Altorjai
- Department of Radiotherapy, Medical University of Vienna, Vienna, Austria
| | - Johannes Pammer
- Department of Clinical Pathology, Medical University of Vienna, Vienna, Austria
| | - Matthaeus Ch Grasl
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Boban M Erovic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
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