Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging

Abstract Objective To investigate the frequency, distribution, and potential factors of lymphatic metastasis at each nodal level, and stratify the risk of lymph node metastasis in hypopharyngeal squamous cell carcinoma based on computed tomography. Methods Contrast‐enhanced computed tomography image...

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Main Authors: Dongqing Wang, Shuguang Zhang, Jin Xu, Limin Zhai, Baosheng Li
Format: Article
Language:English
Published: Wiley 2021-12-01
Series:Precision Radiation Oncology
Subjects:
Online Access:https://doi.org/10.1002/pro6.1137
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author Dongqing Wang
Shuguang Zhang
Jin Xu
Limin Zhai
Baosheng Li
author_facet Dongqing Wang
Shuguang Zhang
Jin Xu
Limin Zhai
Baosheng Li
author_sort Dongqing Wang
collection DOAJ
description Abstract Objective To investigate the frequency, distribution, and potential factors of lymphatic metastasis at each nodal level, and stratify the risk of lymph node metastasis in hypopharyngeal squamous cell carcinoma based on computed tomography. Methods Contrast‐enhanced computed tomography images of 176 patients with pathologically confirmed hypopharyngeal squamous cell carcinoma without any cancer‐related therapeutic history were analyzed retrospectively. The lymphatic metastasis ratio at each nodal level was determined. Potential factors that correlated with lymph node metastasis were identified using univariate and multivariate analyses. Results Metastatic lymph nodes were found in 145 (82.4%) of 176 patients. The lymphatic metastasis ratio was 0.6% (Ia), 4.0% (Ib), 67.6% (IIa), 43.8% (IIb), 45.5% (III), 13.1% (IV), 5.1% (Va), 1.7% (Vb), 1.7% (VIa), 12.5% (VIb), and 15.9% (VII) for each nodal level in the ipsilateral neck. In contrast, a lower lymphatic metastasis ratio was observed in the contralateral neck, with the highest measuring 18.2% at level IIa. Esophageal invasion was highly correlated with an increased risk of developing level VIb metastasis (P = 0.019). Furthermore, posterior pharyngeal wall invasion was highly correlated with an increased risk of level VII metastasis (P = 0.014). Conclusion In general, nodal levels IIa, III, and IIb were highly susceptible to metastasis in the ipsilateral neck. Nodal levels IV, VIb, and VII in the ipsilateral neck, and IIa in the contralateral neck showed a moderate risk of metastasis. Levels I and V were considered low risk. The anatomical characteristics and infiltration of tumors in different subsites should also be considered in the delineation of the clinical target volume.
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spelling doaj.art-57a1f06d775e4fa7a4a232d9e63888572022-12-21T19:24:54ZengWileyPrecision Radiation Oncology2398-73242021-12-015423724310.1002/pro6.1137Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imagingDongqing Wang0Shuguang Zhang1Jin Xu2Limin Zhai3Baosheng Li4Department of Radiation Oncology for Head and Neck Cancer Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan ChinaDepartment of Surgical Oncology for Head and Neck Cancer Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan ChinaDepartment of Radiation Oncology for Head and Neck Cancer Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan ChinaDepartment of Radiation Oncology for Head and Neck Cancer Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan ChinaDepartment of Radiation Oncology for Head and Neck Cancer Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan ChinaAbstract Objective To investigate the frequency, distribution, and potential factors of lymphatic metastasis at each nodal level, and stratify the risk of lymph node metastasis in hypopharyngeal squamous cell carcinoma based on computed tomography. Methods Contrast‐enhanced computed tomography images of 176 patients with pathologically confirmed hypopharyngeal squamous cell carcinoma without any cancer‐related therapeutic history were analyzed retrospectively. The lymphatic metastasis ratio at each nodal level was determined. Potential factors that correlated with lymph node metastasis were identified using univariate and multivariate analyses. Results Metastatic lymph nodes were found in 145 (82.4%) of 176 patients. The lymphatic metastasis ratio was 0.6% (Ia), 4.0% (Ib), 67.6% (IIa), 43.8% (IIb), 45.5% (III), 13.1% (IV), 5.1% (Va), 1.7% (Vb), 1.7% (VIa), 12.5% (VIb), and 15.9% (VII) for each nodal level in the ipsilateral neck. In contrast, a lower lymphatic metastasis ratio was observed in the contralateral neck, with the highest measuring 18.2% at level IIa. Esophageal invasion was highly correlated with an increased risk of developing level VIb metastasis (P = 0.019). Furthermore, posterior pharyngeal wall invasion was highly correlated with an increased risk of level VII metastasis (P = 0.014). Conclusion In general, nodal levels IIa, III, and IIb were highly susceptible to metastasis in the ipsilateral neck. Nodal levels IV, VIb, and VII in the ipsilateral neck, and IIa in the contralateral neck showed a moderate risk of metastasis. Levels I and V were considered low risk. The anatomical characteristics and infiltration of tumors in different subsites should also be considered in the delineation of the clinical target volume.https://doi.org/10.1002/pro6.1137clinical target volumecomputed tomographyhypopharynxlymph nodesquamous cell carcinoma
spellingShingle Dongqing Wang
Shuguang Zhang
Jin Xu
Limin Zhai
Baosheng Li
Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging
Precision Radiation Oncology
clinical target volume
computed tomography
hypopharynx
lymph node
squamous cell carcinoma
title Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging
title_full Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging
title_fullStr Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging
title_full_unstemmed Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging
title_short Analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast‐enhanced computed tomography imaging
title_sort analysis of lymph nodes metastasis in hypopharyngeal squamous cell carcinoma based on contrast enhanced computed tomography imaging
topic clinical target volume
computed tomography
hypopharynx
lymph node
squamous cell carcinoma
url https://doi.org/10.1002/pro6.1137
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AT jinxu analysisoflymphnodesmetastasisinhypopharyngealsquamouscellcarcinomabasedoncontrastenhancedcomputedtomographyimaging
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