- Lymph node metastases:
- At presentation are common in OPSCC:
- With over half of patients:
- Having clinical or radiological evidence of cervical metastasis, and
- Around a third of patients diagnosed as cN0:
- Having pathologic evidence of lymph node metastasis
- With over half of patients:
- The lymphatic drainage from the oropharynx:
- Is mainly to:
- Levels II, III and IV
- It also drains into:
- The retropharyngeal (RP) nodes:
- Which need to be considered in the assessment of disease in this area
- The risk of metastasis to RP lymph nodes depends on subsite:
- A meta-analysis of papers suggests risk of RP lymphadenopathy being:
- 19% for soft palate
- 12% for tonsil
- 6% for base of tongue and
- 21% to 57% for posterior pharyngeal wall tumors:
- Including hypopharynx
- A meta-analysis of papers suggests risk of RP lymphadenopathy being:
- The prognostic impact of positive RP lymph node metastasis is disputed:
- Some authors showing an adverse impact:
- And others not
- Some authors showing an adverse impact:
- The retropharyngeal (RP) nodes:
- Is mainly to:
- A particular feature of OPSCC:
- Is the propensity to metastasis to the contralateral neck:
- This occurring in up to 30% of patients overall in one series:
- The subsites in which this is mostly likely to occur are the:
- Soft palate
- Base of tongue
- Posterior pharyngeal wall:
- However:
- Even tonsil cancers have an approximate rate:
- Of contralateral nodal spread of 10%
- Even tonsil cancers have an approximate rate:
- However:
- The subsites in which this is mostly likely to occur are the:
- This occurring in up to 30% of patients overall in one series:
- Is the propensity to metastasis to the contralateral neck:
- At presentation are common in OPSCC:
#Arrangoiz #HeadandNeckSurgeon #HeadandNeckCancer #CancerSurgeon #SurgicalOncologist
Rodrigo Arrangoiz MS, MD, FACS, FSSO 