Prevalence and risk factors for retropharyngeal and retro-styloid lymph node metastasis in hypopharyngeal carcinoma

Radiation Oncology

Research

Shinya Shiraishi¹  Toshinori Hirai¹  Yorihisa Orita²  Daizo Murakami²  Yoshiyuki Fukugawa³  Tomohiko Matsuyama³  Takahiro Watakabe³  Natsuo Oya³  Tetsuo Saito³  Ryo Toya⁴ 

[1] Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan;Department of Otolaryngology-Head and Neck Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan;Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan;Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan;Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan;

关键词: Head and neck cancer;    Radiotherapy;    Hypopharyngeal carcinoma;    Lymph node metastasis;    Retropharyngeal lymph node;    Retro-styloid lymph node;    Magnetic resonance imaging;    Positron emission tomography;    Clinical target volume;   

DOI  :  10.1186/s13014-023-02322-4

 received in 2023-04-27, accepted in 2023-07-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWe evaluated the prevalence and identified the risk factors for retropharyngeal and retro-styloid lymph node metastasis (LNM) in patients with hypopharyngeal carcinoma (HPC). This was achieved using a combination of magnetic resonance (MR) and [18 F]-fluoro-2-deoxy-D-glucose (FDG)–positron emission tomography (PET)/computed tomography (CT) images.MethodsTwo board-certified radiation oncologists retrospectively reviewed pretreatment FDG–PET/CT images and contrast-enhanced thin-slice CT and MR images of 155 patients with HPC who underwent radiotherapy. Fisher’s exact tests and logistic regression analyses were performed to assess the risk factors for LNM.ResultsRetropharyngeal LNM (RPLNM) was confirmed in 20 (13%) patients. Posterior wall (PW) tumors (odds ratio [OR]: 4.128, 95% confidence interval [CI]: 1.339–12.727; p = 0.014) and bilateral or contralateral cervical LNM (OR: 11.577, 95% CI: 2.135–62.789; p = 0.005) were significantly correlated with RPLNM. The RPLNM was found in 9 (32%) of the 28 patients with PW tumors. Of these 9 patients, 2 (7%) had ipsilateral RPLNM, 3 (11%) had contralateral RPLNM, and 4 (14%) had bilateral RPLNM. The PW tumors were significantly associated with contralateral RPLNM (p < 0.001). Retro-styloid LNM (RSLNM) was confirmed in two (1%) patients, both of whom had ipsilateral RSLNM with lymph nodes (LNs) of ≥ 15 mm in the upper limit of ipsilateral level II. A significant association was found between LNs of ≥ 15 mm in the upper limit of ipsilateral level II and ipsilateral RSLNM (p = 0.001).ConclusionsThe RPLNM was identified in 13% of patients with HPC. The PW tumors and bilateral or contralateral cervical LNM were risk factors for RPLNM; particularly, PW tumors were a specific risk factor for contralateral RPLNM. Although the RSLNM was rare, LNs of ≥ 15 mm in the upper limit of ipsilateral level II were a risk factor for ipsilateral RSLNM.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 1