How do histopathologIcal fIndIngs affect cervical lymph metastasis in laryngeal cancer? A RETROSPECTIVE STUDY AND LITERATURE REVIEW

Year 2019, Volume: 9 Issue: 1, 11 - 17, 19.03.2019

Seyda Belli , Metin Yıldırım Funda Emre Kaya Tolga Bilece Mehmet Faruk Oktay

https://doi.org/10.32448/entupdates.536842

Abstract

Purpose: This study aimed to elucidate how histopathological findings relate to the existence of metastases in lymph nodes in a cohort of surgical cases with squamous cell carcinoma of the larynx.

Material and Methods: A cohort of cases from the ENT department, who had partial or total laryngectomy and dissection of the neck in the period spanning January 2008 to June 2017 were evaluated retrospectively. 150 cases were deemed appropriate for inclusion in the study. The histopathological notes and clinical findings of these cases were compared to each other. 

Findings: The glottic group had lower levels of lymphovascular invasion (p<0.05). Tumours staged at T3 or T4 level or endophytic in subtype were, however, more likely to have lymphovascular invasive features (p<0.05). For neoplasms with a high degree of differentiation, it was less frequent to observe invasion of lymphatics, metastasis to the cervical nodes or invasion beyond the capsule (p<0.05). Perineural invasion was not associated with a greater risk of the neoplasm metastasizing to the cervical lymphovasculature, but invasion of the lymphatics did signal an increase in metastasis (p<0.05).

Conclusion:Cervical lymphatic metastasis of squamous cell carcinoma of the larynx has a high degree of correlation with histopathological grading.

Keywords

Laryngeal cancer, perineural invasion, lymphovascular invasion

References

• 1. Gastardelo TS, Cunha BR, Raposo LS, et al. Inflammation and Cancer: Role of Annexin A1 and FPR2/ALX in Proliferation and Metastasis in Human Laryngeal Squamous Cell Carcinoma . PLoS One. 2014 Dec 9;9(12):e111317. doi: 10.1371/journal.pone.0111317. eCollection 2014.
• 2. McGavran MH, Bauer WC, Ogura JH . The incidence of cervical lymph node metastasis from epidermoid carcinoma of the larynx and their relationship to certain characteristics of the primary tumor. A study based on the clinical and pathological findings for 96 patients treated by primary en bloc laryngectomy and radical neck dissection. Cancer.1961;14:55–56. PMID: 13773928
• 3. Imre A, Pinar E, Dincer E, et al. Lymph Node Density in Node-Positive Laryngeal Carcinoma: Analysis of Prognostic Value for Survival. Otolaryngol Head Neck Surg. 2016 Nov;155(5):797-804. Epub 2016 May 24. DOI: 10.1177/0194599816652371 PMID: 27221573
• 4. Iovănescu GH, Poenaru M, Doroş C, et al. Histopathological prognostic and risk factors in patients with laryngeal neoplasms. Rom J Morphol Embryol. 2013;54(4):1087-92. PMID: 24399006
• 5. Ozdek A, Sarac S, Akyol MU, et al. Histopathological predictors of occult lymph node metastasesin supraglottic squamous cell carcinomas. Eur Arch Otorhinolaryngol. 2000;257 :389–92. PMID: 11052252
• 6. Matsushita Y, Yanamoto S, Takahashi H, et al. A clinicopathological study of perineural invasion and vascular invasion in oral tongue squamous cell carcinoma. Int. J. Oral Maxillofac. Surg. 2015; 44: 543–8. DOI: 10.1016/j.ijom.2015.01.018 PMID: 25697063
• 7. Chirilă M, Bolboacă SD, Cosgarea M, et al. Perineural invasion of the major and minor nerves in laryngeal and hypopharyngeal cancer. Otolaryngology–Head and Neck Surgery. 2009;140:65-9. DOI: 10.1016/j.otohns.2008.10.019 PMID: 19130964 8. Feasel AM, Brown TJ, Bogle MA, et al. Perineural invasion of cutaneous malignancies. Dermatol Surg. 2001;27:531– 42. PMID: 11442588
• 9. Ampil FL, Hardin JC, Peskind SP, et al. Perineural invasion in skin cancer of the head and neck: review of nine cases. J Oral Maxillofac Surg. 1995;53:34 – 8. PMID: 7799119
• 10. Kurtz KA, Hoffman HT, Zimmerman MB, et al. Perineural and vascular invasion in oral cavity squamous carcinoma: increased incidence on re-review of slides and by using immunohistochemical enhancement. Arch Pathol Lab Med. 2005; 129:354–9. DOI: 10.1043/1543-2165(2005)129<354:PAVIIO>2.0.CO;2 PMID: 15737030
• 11. Furtado de Araújo Neto VJ, Cernea CR, Aparecido Dedivitis R, et al. Cervical metastasis on level IV in laryngeal cancer. Acta Otorhinolaryngol Ital. 2014 Feb;34(1):15-8. PMID: 24711678
• 12. Mamelle G, Pampurik J, Luboinski B, et al. Lymph node prognostic factors in head and neck squamous cell carcinomas. Am J Surg. 1994 Nov;168(5):494-8. PMID: 7977983
• 13. Fletcher KT, Gal TJ, Ebelhar AJ, et al. Prognostic indicators and survival in salvage surgery for laryngeal cancer. Head Neck. 2017;39:2021-6. DOI: 10.1002/hed.24860 PMID: 28681422 14. Mendenhall WM, Ferlito A, Takes RP, et al. Cutaneous head and neck basal and squamous cell carcinomas with perineural invasion. Oral Oncol. 2012;48:91822. DOI: 10.1016/j.oraloncology.2012.02.015 PMID: 2425152
• 15. Fagan JJ, Colins B, Barnes L, et al. Perineural invasion in squamous cell carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg. 1998;124:640– 7. PMID: 9639472
• 16. Chirila M, Bolboaca SD, Cosgarea M, et al. Perineural invasion of the major and minor nerves in laryngeal and hypopharyngeal cancer. Otolaryngol Head Neck Surg. 2009;140:65–9. DOI: 10.1016/j.otohns.2008.10.019 PMID: 19130964 17. Soo KC, Carter RL, O’Brien CJ, et al. Prognostic implications of perineural spread in squamous carcinomas of the head and neck. Laryngoscope. 1986;96: 1145–8. PMID: 3762289
• 18. hatzistefanou I, Lubek J, Markou K, et al. The role of neck dissection and postoperative adjuvant radiotherapy in cN0 patients with PNI-positive squamous cell carcinoma of the oral cavity. Oral Oncol. 2014;50:753–8. DOI: 10.1016/j.oraloncology.2014.05.005 PMID: 24909939 19. Ballantyne AJ, McCarte AB, Ibanez ML. The extension of cancer of the head and neck through peripheral nerves. Am J Surg. 1963;36:269-75. PMID: 14070757
• 20. Yilmaz T, Turan E, Gürsel B, et al. Positive surgical margins in cancer of the larynx, Eur Arch Otorhinolaryngol. 2001;258:188–91. PMID: 11407451
• 21. Bittar RF, Ferraro HP, Ribas MH, et al. Predictive factors of occult neck metastasis in patients with oral squamous cell carcinoma. Braz J Otorhinolaryngol. 2016;82:543-7. DOI: 10.1016/j.bjorl.2015.09.005 PMID: 26749457 22. Bennett SH, Futrell JW, Roth JA, et al. Prognostic significance of histologic host response in cancer of the larynx or hypopharynx. Cancer. 1971;28:1255–65. PMID: 5125672
• 23. Eskiizmir G, Tanyeri Toker G, Celik O, et al. Predictive and prognostic factors for patients with locoregionally advanced laryngeal carcinoma treated with surgical multimodality protocol. Eur Arch Otorhinolaryngol. 2017 Mar;274(3):1701-1711. doi: 10.1007/s00405-016-4411-9. Epub 2016 Dec 10. PMID: 27942895
• 24. Santos TS, Estêvão R, Antunes L, et al. Clinical and histopathological prognostic factors in locoregional advanced laryngeal cancer. J Laryngol Otol. 2016 Oct;130(10):948-953. doi: 10.1017/S002221511600880X. PMID:27774922
• 25. Moe K, Wolf GT, Fisher SG,et al. Regional metastases in patients with advanced laryngeal cancer. Department of Veterans Affairs Laryngeal Cancer Study Group. Arch Otolaryngol Head Neck Surg. 1996 Jun;122(6):644-8. PMID: 8639297