Effects of irradiation of cervical lymph nodes

Prognostic factors of patients with nasopharyngeal carcinoma

This study included 2761 previously untreated NPC patients who were treated at National Taiwan University Hospital from 1969 to 1983. Factors affecting the prognosis revealed that initial staging played an important role. Younger male NPC patients survived better than the older ones. Female NPC patients were stronger than male NPC patients. A new histopathologic classification of NPC based on the cell type and degree of anaplasia was found to be well correlated to the survival rates. Excisional neck biopsy before definite initial treatment deteriorated the survival of NPC patients. That no excisional neck biopsy should be done unless NPC can be excluded in patients with upper neck nodes is strongly emphasized. Since combined regimens of low-dose chemotherapy and radiotherapy improved the results of NPC patients, a further control study using the same protocol is strongly recommended.

Laryngeal spaces and lymphatics: current anatomic concepts

This investigation evaluates the anatomic concepts of individual spaces or compartments within the larynx by isotope and dye diffusion. The authors identified continuity of spaces particularly within the submucosal planes and a relative isolation within the fixed structures resulting from the longitudinal pattern of fibroelastic tissues, muscle bands, and perichondrium. The historical data of anatomic resistance are refuted by the radioisotope patterns of dispersion and the histologic evidence of tissue permeability to the carbon particles. There is little clinical application of the compartment concept to the perimeter of growth and the configuration of extensive endolaryngeal cancers. The internal and extralaryngeal lymphatic network is presented and the regional associations are identified. The normal ipsilateral relationship is distorted by dispersion within the endolarynx supervening the anatomic midline. The effects of lymphatic obstruction caused by regional lymphadenectomy, tumor fixation, and irradiation-infection sequelae are illustrated; these result in widespread bilateral lymphatic nodal terminals. Finally, the evidence suggests that the internal network is modified by external interruption to accommodate an outflow system in continuity with the residual patent lymphatic channels.