Lymphnode metastasis patterns in primary sites of hypopharyngeal cancer: A retrospective analysis from multicenter data.

e18559 Background: Understanding the pattern of lymph node metastasis (LNM) in hypopharyngeal cancers (HPC) could help both surgeons and radiologists make decisions in the management of cervical lymph node. Our objective is to identify the pattern of nodal spread and the relationship between features of primary tumor and LNM in HPC. Methods: 244 newly diagnosed HPC patients during 2014 to 2017 were recruited from 3 specialized cancer hospitals in mainland China. All patients underwent head and neck magnetic resonance imaging(MRI) and received definitive radiotherapy ± concurrent chemotherapy. The features of primary tumor (tumor size, primary location, and extent of invasion) and the involvement of lymph nodes in each level were reassessed. According to the incidence of LNM, these levels were sequenced and sorted into drainage stations. Meanwhile, univariate and multivariate analysis was used to determine the risk factors for bilateral and regional lymph node metastasis. Results: The cohort consisted 195 piriform sinus cancers (PSC), 47 posterior wall cancers (PWC), 2 Post-cricoid cancers (PCC). 176 patients (72.1%) presented with MRI-detectable LNM. The overall LNM rates for level II-VI and retropharyngeal lymph nodes (RPLNs) were 59.0%, 52.9%, 14.3%, 1.6%, 2.9% and 14.7% respectively. Based on the prevalence of LNM in each level, we suppose that the lymphatic drainage of PSC was carried out in sequence along three stations: Level II & III (61.0% & 55.4%), Level IV & RPLN (15.9% & 10.3%), and Level V & VI(1.5% & 3.1%). While, for PWC the lymphatic drainage is carried out along two stations: Level II, III & RPLN (48.9%,40.4% & 34.0%), and Level IV-VI (6.4%, 0% and 2.1%). According to univariate analysis, primary subsite, posterior wall, post-cricoid and non-pyriform sinus invasion were correlated with bilateral LNM. The presence of RPLNs was correlated with larger tumor size(>4cm), primary subsite, posterior wall and non-pyriform sinus invasion. In further multivariate analysis, posterior wall invasion was significantly correlated with bilateral LNM (P = 0.030, HR = 2.853 95%CI, 1.110-7.338). Tumor size > 4cm(P = 0.017, HR = 2.545, 95%CI,1.180-5.488) and posterior wall invasion(P = 0.017, HR = 2.880 95%CI, 1.209-6.862) were correlated with RPLN metastasis. Conclusions: Different primary sites of HPC have different lymphnode metastasis patterns. Piriform sinus cancer tends to metastasize to the ipsilateral Level II&III. Posterior wall cancer tends to metastasize bilaterally to Level II, III and RPLN.

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Different Primary Sites of Hypopharyngeal Cancer Have Different Lymph Node Metastasis Patterns: A Retrospective Analysis From Multi-Center Data

Frontiers in Oncology ◽

10.3389/fonc.2021.727991 ◽

2021 ◽

Vol 11 ◽

Author(s):

Xiwei Zhang ◽

Ye Zhang ◽

Xiaoduo Yu ◽

Ying Sun ◽

Susheng Miao ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Primary Tumor ◽

Multivariate Analyses ◽

Posterior Wall ◽

Lymphatic Drainage ◽

Primary Tumor Site ◽

Node Metastasis ◽

Level Ii

BackgroundMost hypopharyngeal cancers (HPCs) develop lymph node metastasis (LNM) at initial diagnosis. Understanding the pattern of LNM in HPC could help both surgeons and radiologists make decisions in the management of cervical lymph nodes.MethodsA total of 244 newly diagnosed HPC patients between January 2010 and December 2018 were recruited from three specialized cancer hospitals in mainland China. All patients received pre-treatment magnetic resonance imaging (MRI), and definitive radiotherapy with or without concurrent chemotherapy. We reassessed the features of the primary tumor (tumor size, primary location, and extent of invasion) and the involvement of lymph nodes at each level. According to the incidence of LNM, these levels were sequenced and sorted into drainage stations. Univariate and multivariate analyses were used to determine the risk factors for bilateral and regional lymph node metastasis.ResultsThe cohort consisted of 195 piriform sinus cancers (PSC), 47 posterior wall cancers (PWC), and 2 post-cricoid cancers (PCC). A total of 176 patients (72.1%) presented with MRI-detectable LNMs. The overall LNM rates for level II-VI and retropharyngeal lymph nodes (RPLNs) were 59.0%, 52.9%, 14.3%, 1.6%, 2.9%, and 16.4%, respectively. Based on the prevalence of LNM at each level, we hypothesize that the lymphatic drainage of PSC was carried out in sequence along three stations: Level II and III (61.0% and 55.4%), Level IV and RPLN (15.9% and 11.3%), and Level V and VI (1.5% and 3.1%). For PWCs, lymphatic drainage is carried out at two stations: Level II, III, and RPLN (48.9%, 40.4%, and 34.0%) and Level IV-VI (6.4%, 0%, and 2.1%). According to univariate and multivariate analyses, posterior wall invasion was significantly correlated with bilateral LNM (P = 0.030, HR = 2.853 95%CI, 1.110-7.338) and RPLN metastasis (P = 0.017, HR = 2.880 95%CI, 1.209-6.862). However, pyriform sinus invasion was less likely to present with bilateral LNM (P = 0.027, HR = 0.311, 95%CI, 0.111-0.875) and RPLN metastasis (P = 0.028, HR = 0.346, 95%CI, 0.134-0.891).Conclusions and RelevanceThe primary tumor site and extent of invasion are related to the pattern of lymph node metastasis. That is, the metastasis would drainage station by station along different directions.

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EVALUATION OF CLINICAL AND PARACLINICAL FEATURES IN PATIENTS WITH CARCINOMA OF ORAL CAVITY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.5.9 ◽

2016 ◽

pp. 56-60

Author(s):

Van Minh Nguyen ◽

Hong Loi Nguyen ◽

Thi Kim Anh Dang

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Oral Cavity ◽

Tumor Size ◽

Regional Lymph Node ◽

Regional Lymph Node Metastasis ◽

Female Ratio ◽

Histopathological Grade ◽

Node Metastasis ◽

Metastasis Rate

Background: To evaluate the clinical, hystopathologycal features and correlation between lymph node metastasis and hystopathologycal grade in patients with carcinoma of the oral cavity. Materials and Methods: From July 2015 to July 2016, 32 patients with carcinoma of the oral cavity at Hue Central Hospital Results: The most common age group from 51 to 60 years and the male/female ratio was 1.9/1. Tumor were usually observed around the the tongue (40.6%) and oral floor (34.4%). Most of the tumor size is larger than 2 cm diameters (> 80%). The regional lymph node metastasis rate was 43.8% and there was a positive correlation between lymph node metastasis and tumor size (p <0.05). Squamous-cell carcinoma was mainly type of histopathology. Difference between the rate of lymph node metastasis in patient groups with different histopathological grade show no statistical significance (p> 0.05). Conclusion: the greater tumor, the higher regional lymph node metastasis. There is no relationship between the lymph node metastasis rate and histopathological grade of oral carcinoma. Key words: : carcinoma of oral cavity, tumor size, lymph node metastasis, histopathology

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Significance of Concurrent Chemoradiotherapy as Primary Treatment in Patients with Metastatic Cervical Cancer

Current Oncology ◽

10.3390/curroncol28030155 ◽

2021 ◽

Vol 28 (3) ◽

pp. 1663-1672

Author(s):

Satomi Hattori ◽

Nobuhisa Yoshikawa ◽

Kazumasa Mogi ◽

Kosuke Yoshida ◽

Masato Yoshihara ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Tumor Size ◽

Concurrent Chemoradiotherapy ◽

Primary Treatment ◽

Prognostic Impact ◽

Primary Tumor Size ◽

Node Metastasis ◽

Aortic Lymph Node

(1) This study investigated the prognostic impact of tumor size in patients with metastatic cervical cancer. (2) Methods: Seventy-three cervical cancer patients in our institute were stratified into two groups based on distant metastasis: para-aortic lymph node metastasis alone (IIIC2) or spread to distant visceral organs with or without para-aortic lymph node metastasis (IVB) to identify primary tumor size and concurrent chemoradiotherapy. (3) Results: The overall survival (OS) for patients with a tumor >6.9 cm in size was significantly poorer than that for patients with a tumor ≤6.9 cm in the IVB group (p = 0.0028); the corresponding five-year OS rates in patients with a tumor ≤6.9 and >6.9 cm were 53.3% and 13.4%, respectively. In the multivariate analysis, tumor size and primary treatment were significantly associated with survival in metastatic cervical cancer. (4) Conclusions: Tumor size ≤6.9 cm and concurrent chemoradiotherapy as the primary treatment were favorable prognostic factors for patients with metastatic cervical cancer.

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Polymorphisms in HIF-1alpha affect presence of lymph node metastasis and can influence tumor size in squamous-cell carcinoma of the glottic larynx

Clinical & Translational Oncology ◽

10.1007/s12094-012-0930-z ◽

2012 ◽

Vol 15 (5) ◽

pp. 358-363 ◽

Cited By ~ 8

Author(s):

F. Mera-Menéndez ◽

A. Hinojar-Gutiérrez ◽

M. Guijarro Rojas ◽

J. García de Gregorio ◽

E. Mera-Menéndez ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Cell Carcinoma ◽

Squamous Cell ◽

Tumor Size ◽

Node Metastasis

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Total Sentinel Lymph Node Tumor Size Predicts Nonsentinel Node Metastasis and Survival in Patients with Melanoma

Annals of Surgical Oncology ◽

10.1245/s10434-010-1145-6 ◽

2010 ◽

Vol 17 (11) ◽

pp. 3015-3020 ◽

Cited By ~ 22

Author(s):

Ali Cadili ◽

Richard A. Scolyer ◽

Philip T. Brown ◽

Kelly Dabbs ◽

John F. Thompson

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Tumor Size ◽

Node Metastasis ◽

Nonsentinel Node

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The role of microvessel density, lymph node metastasis, and tumor size as prognostic factors of distant metastasis in colorectal cancer

Oncology Letters ◽

10.3892/ol.2017.5959 ◽

2017 ◽

Vol 13 (6) ◽

pp. 4327-4333 ◽

Cited By ~ 8

Author(s):

Tomonari Cho ◽

Eisuke Shiozawa ◽

Fumihiko Urushibara ◽

Nana Arai ◽

Toshitaka Funaki ◽

...

Keyword(s):

Colorectal Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Distant Metastasis ◽

Microvessel Density ◽

Tumor Size ◽

Node Metastasis

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Development of Nomograms for Predicting Lymph Node Metastasis and Distant Metastasis in Newly Diagnosed T1-2 Non-Small Cell Lung Cancer: A Population-Based Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.683282 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yiming Qi ◽

Shuangshuang Wu ◽

Linghui Tao ◽

Yunfu Shi ◽

Wenjuan Yang ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Small Cell Lung Cancer ◽

Distant Metastasis ◽

Tumor Size ◽

Small Cell ◽

Small Cell Lung ◽

Node Metastasis

BackgroundFor different lymph node metastasis (LNM) and distant metastasis (DM), the diagnosis, treatment and prognosis of T1-2 non-small cell lung cancer (NSCLC) are different. It is essential to figure out the risk factors and establish prediction models related to LNM and DM.MethodsBased on the surveillance, epidemiology, and end results (SEER) database from 1973 to 2015, a total of 43,156 eligible T1-2 NSCLC patients were enrolled in the retrospective study. Logistic regression analysis was used to determine the risk factors of LNM and DM. Risk factors were applied to construct the nomograms of LNM and DM. The predictive nomograms were discriminated against and evaluated by Concordance index (C-index) and calibration plots, respectively. Decision curve analysis (DCAs) was accepted to measure the clinical application of the nomogram. Cumulative incidence function (CIF) was performed further to detect the prognostic role of LNM and DM in NSCLC-specific death (NCSD).ResultsEight factors (age at diagnosis, race, sex, histology, T-stage, marital status, tumor size, and grade) were significant in predicting LNM and nine factors (race, sex, histology, T-stage, N-stage, marital status, tumor size, grade, and laterality) were important in predicting DM(all, P< 0.05). The calibration curves displayed that the prediction nomograms were effective and discriminative, of which the C-index were 0.723 and 0.808. The DCAs and clinical impact curves exhibited that the prediction nomograms were clinically effective.ConclusionsThe newly constructed nomograms can objectively and accurately predict LNM and DM in patients suffering from T1-2 NSCLC, which may help clinicians make individual clinical decisions before clinical management.

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Indications of Lymph Node Metastasis and Survival Analysis in T1N+M0 Gastric Cancer: a Population-Based Study

10.21203/rs.3.rs-36648/v1 ◽

2020 ◽

Author(s):

Peng Jin ◽

Yang Li ◽

Shuai Ma ◽

Wenzhe Kang ◽

Hao Liu ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Survival Analysis ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Tumor Size ◽

Multivariate Analyses ◽

Invasion Depth ◽

Node Metastasis ◽

Definition Of

Abstract Background Since the definition of early gastric cancer (EGC) was first proposed in 1971, the treatment of gastric cancer with or without lymph node metastasis (LNM) has changed a lot. The present study aims to identify risk factors for LNM and prognosis, and to further evaluate the indications for adjuvant chemotherapy (AC) in T1N + M0 gastric cancer. Methods A total of 1291 patients with T1N + M0 gastric cancer were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate analyses were performed to identify risk factors for LNM. The effect of LNM on overall survival (OS) and cancer-specific survival (CSS) was compared with patients grouped into T1N0-1 and T1N2-3, as the indications for AC. Results The rate of LNM was 19.52%. Multivariate analyses showed age, tumor size, invasion depth, and type of differentiation and retrieved LNs were associated with LNM (p < 0.05). Cox multivariate analyses indicated age, sex, tumor size, N stage were independent predictors of OS and CSS (p < 0.05), while race was indicator for OS (HR 0.866; 95%CI 0.750–0.999, p = 0.049), but not for CSS (HR 0.878; 95% CI 0.723–1.065, p = 0.187). In addition, survival analysis showed the proportion of patients in N+/N0 was better distributed than N0-1/N2-3b. There were statistically significant differences in OS and CSS between patients with and without chemotherapy in pT1N1M0 patients (p༜0.05). Conclusions Both tumor size and invasion depth are associated with LNM and prognosis. LNM is an important predictor of prognosis. pT1N + M0 may be appropriate candidates for AC. Currently, the treatment and prognosis of T1N0M0/T1N + M0 are completely different. An updated definition of EGC, taking into tumor size, invasion depth and LNM, may be more appropriate in an era of precision medicine.

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