Paratracheal lymph node dissection, in which patients should it be performed?

Yıl 2016, Cilt: 26 Sayı: 4, 213 - 218, 10.09.2016

Şenol Çomoğlu Ece Çomoğlu Necati Enver Eren Yılmaz Mehmet Çelik Beldan Polat Murat Ulusan İsmet Aslan Kemal Değer

Öz

Objectives: This study aims to evaluate the effect of paratracheal lymph node PTLN metastasis on survival in patients with advanced laryngeal and hypopharyngeal cancer. Patients and Methods: Medical records of advanced laryngeal and hypopharyngeal cancers who underwent surgery between May 1995 and June 2008 were assessed and 78 of the patients 63 males, 15 females; mean age 55±11.3 years; range 25 to 76 years who has PTLN metastasis were included in this study. The mean follow-up period was 23 months. Fifty-three patients had primary laryngeal cancer, and the remaining 25 patients had primary hypopharyngeal cancer. Results: Paratracheal lymph node metastasis was detected in eight 15% of 53 patients with laryngeal carcinoma, six 42% of 14 patients with postcricoid carcinoma, and one 14% of seven patients with posterior pharyngeal wall carcinoma. Paratracheal lymph node metastasis was not detected in patients with pyriform sinus carcinoma n=4 . Paratracheal lymph node metastasis was detected in a total of 15 patients, of whom 11 had extranodal spread ENS . Multivariate analysis showed that the presence of ENS was the most effective prognostic factor on the overall survival p<0.0005 . Conclusion: The presence of PTLN metastasis with ENS is an important prognostic indicator on overall survival. We recommend PTLN dissection particularly in patients with advanced laryngeal or hypopharyngeal cancer for histopathological analysis and prognostication because ENS can only be precisely detected by pathological evaluation.

Anahtar Kelimeler

Head and neck cancer, hypopharynx, larynx, paratracheal lymph node metastasis, prognosis, total laryngectomy

Paratrakeal lenf nodu diseksiyonu hangi hastalarda uygulanmalıdır?

Öz

Amaç: Bu çalışmada paratrakeal lenf nodu PTLN metastazının ileri evre larengeal ve hipofarenks kanseri hastalarında sağkalıma etkisi değerlendirildi.Hastalar ve Yöntemler: Mayıs 1995 - Haziran 2008 tarihleri arasında ameliyat olan ileri evre larengeal ve hipofarengeal kanserli hastaların tıbbi kayıtları değerlendirildi ve PTLN metastazı olan hastaların 78’i 63 erkek, 15 kadın; ort. yaş 55±11.3 yıl; dağılım 25-76 yıl çalışmaya dahil edildi. Ortalama izlem süresi 23 aydı. Elli üç hasta primer larenks kanseri ve kalan 25 hasta primer hipofarengeal kanseri idi.Bulgular: Paratrakeal lenf nodu metastazı 53 hastanın sekizinde %15 larenks kanseri ile, 14 hastanın altısında %42 postkrikoid kanseri ile, ve yedi hastanın birinde %14 ise yutak arka duvar kanseri ile tespit edildi. Paratrakeal lenf nodu metastazı, hipofarenksin piriform sinüsünden gelişen kanserli hastalarda tespit edilmedi n=4 . Paratrakeal lenf nodu metastazı 11’inde ekstranodal yayılması ENS olan toplam 15 hastada saptandı. Çoklu analizler ENS varlığının genel sağkalım üzerinde en etkili prognostik faktör olduğunu gösterdi p

Anahtar Kelimeler

Baş ve boyun kanseri, hipofarenks, larenks, paratrakeal lenf nodu metastazı, prognoz, total larenjektomi

Kaynakça

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