Incidence and patterns of retropharyngeal lymph node involvement in oropharyngeal carcinoma.

Radiother Oncol 2020 01 17;142:92-99. Epub 2019 Aug 17.

Department of Clinical Oncology, Leeds Cancer Centre, UK. Electronic address:

Introduction: The aim was to evaluate in oropharyngeal carcinoma the: (1) incidence and predictors of retropharyngeal (RP) lymph node (LN) involvement, (2) pattern of ipsilateral/bilateral/contralateral-only RP LNs (3) location of RP LNs in relation to contouring guidelines.

Methods: Single centre retrospective analysis of 402 patients with oropharyngeal carcinoma treated non-surgically between 2010 and 2017. All patients had a baseline FDG PET-CT and contrast-enhanced MRI and/or CT. All cases with reported abnormal RP LNs underwent radiology review.

Results: Abnormal RP LNs were identified in 40/402 (10%) of patients. On multivariate analysis, RP LN involvement was associated with posterior pharyngeal wall/soft palate primaries (OR 10.13 (95% CI 2.29-19.08), p = 0.002) and contralateral cervical LN involvement (OR 2.26 (95% CI 1.05-4.86), p = 0.036). T stage, largest LN size, levels of ipsilateral LN level involvement, HPV and smoking status did not predict risk. 5/402 (1.2%) patients had bilateral RP involvement. 3/402 patients (0.7%) had contralateral-only RP LNs. All patients with contralateral RP LNs had contralateral neck nodes or primary cancers extending across midline. In 5/40 (12.5%) cases with involved RP LNs, the RP LNs were superior to hard palate/upper edge of body of C1 vertebra.

Conclusions: RP LNs were identified in 10% of oropharyngeal carcinoma patients, and were associated with contralateral neck disease and/or posterior pharyngeal wall/soft palate primary. Contralateral RP LN involvement was rare and associated with contralateral neck disease and/or primary crossing midline, suggesting potential for omission from target volumes for selected patients. Involvement of RP LNs close to the skull base highlights the need for generous elective outlining.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.radonc.2019.07.021DOI Listing
January 2020

Publication Analysis

Top Keywords

oropharyngeal carcinoma
16
contralateral neck
12
lns
10
posterior pharyngeal
8
disease and/or
8
abnormal lns
8
patients
8
node involvement
8
pharyngeal wall/soft
8
wall/soft palate
8
associated contralateral
8
involvement
8
neck disease
8
retropharyngeal lymph
8
lns identified
8
lymph node
8
contralateral
6
105-486 p = 0036
4
contralateral involvement
4
95% 105-486
4

Similar Publications