Regional Metastases in Hypopharyngeal Carcinoma

  • In more than 80% of patients:
    • Tumors spread to involve the local lymph nodes:
      • Are detected on physical examination or by imaging at first presentation
  • The lymphatics fluid flows mostly via collectors:
    • Into the lymph nodes of levels II and III:
      • A direct relationship to:
        • Level I has not been detected
    • Drainage to involve level IV:
      • Occurs frequently
  • The lymphatic drainage of the posterior pharyngeal wall:
    • Occurs mainly first into the retropharyngeal lymph nodes:
      • And accounts for over 40% of cases
  • In hypopharyngeal cancers:
    • Because of its advanced stage at presentation and its involvement or extension to cross the midline:
      • The risk of contralateral metastases:
        • Is high:
          • With histological identification of tumor:
            • In more than 20% of cases treated surgically:
              • And supports the therapeutic decision to treat both sides of the neck:
                • Either by surgery or by radiotherapy in the N0 neck

#Arrangoiz #HeadandNeckSurgeon #CancerSurgeon #SurgicalOncologist #Teacher

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