Lymph Node Involvement In Upper Aerodigestive Tract Cancers - A Clinical Study at Specialities University Hospital of Rabat.
Introduction: Cervical lymph node involvement has a major impact on prognosis and treatment decisions in patients with upper aerodigestive tract (UADT) cancer.
Objective: The aim of this study was to assess the incidence and pattern of cervical lymph node (LN) metastases in cancers of the upper aerodigestive tract
Methods: This prospective study was conducted by the Department of ENT and Maxillofacial Surgery at Specialities University Hospital of Rabat, collecting data between October 2009 and December 2011. Lymph nodes were counted, clinically and radiologically localized, excised, then studied histologically.
Results: During this period, 106 patients have been treated surgically with a recent diagnosis of UADT cancer. The average age of our patients was 55±13.3 years, while male/female ratio was 3.5 to 1. More than half of our patients were operated with cancer of the larynx (58.5%, n=62); 27.4% (n=29) of patients suffered from oral cavity cancer and 14.2% (n=15) had cancer of the hypopharinx. Cervical lymph node invasion was estimated at 31.2% clinically, and 38.7% radiologically and histologically, distributed in different sites.
Although the percentage of the invasion is almost similar clinically, radiologically and histologically, the high number of false positives and true negatives according to clinical and radiological exams confirms that specificity and sensitivity of these two exams is still poor compared to histology.
Conclusion: Thus, cervical metastases have to be diagnosed histologically. Moreover, the low percentage of lymph node invasions in the case of a UADT cancer suggests that the use of sentinel lymph node technique could be important, as it has been validated for small T1T2N0 tumors in the oral cavity. Further studies are needed to confirm its validity in case of other UADT tumor types.
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