Nodal Status of the Head and Neck Cancer Patients

Yang,  Dae Sik; Choi,  Myung Sun; Choi,  Jong Ouck

J Korean Soc Ther Radiol > Volume 15(4); 1997 > Article

Original Article

Journal of the Korean Society for Therapeutic Radiology 1997;15(4): 321-330.

Nodal Status of the Head and Neck Cancer Patients

Dae Sik Yang, Myung Sun Choi, Jong Ouck Choi

¹Department of Radiation Oncology, Korea University College of Medicine, Medical Center, Seoul, Korea.
²Department of Otolaryngology, Korea University College of Medicine, Medical Center, Seoul, Korea.

ABSTRACT

PURPOSE:
It is well known that the risk of lymph nodes metastases to head and neck cancers are influenced by the location and size of the primary tumor, as well as the degree and types of histological differentiation. However, data on the statistical analyses of lymph node metastases from the head and neck cancers among Korean population are not available at present. In order to obtain current status of such data, we have analyzed cancer patients at the department of radiation oncology, Korea university hospital for radiation treatment.
MATERIALS AND METHODS:
We have evaluated nine-hundred and ninetyseven (997) head and neck cancer patients who visited to the Department of radiation oncology, between November 1981 to December 1995. After careful physical examinations and CAT scan, patients were divided into two groups, those with positive lymph node metastases and with negative lymph node metastases. The nodal status were classified according to the TNM system of American Joint Committee on Cancer (AJCC)
RESULTS:
Four-hundred and sixteen patients out of the 997 patients were lymph node positive (42%) and 581 patients were lymph node negative (58%) when they were first presented at the department of radiation oncology. According to the AJCC classification, the distribution of positive lymph node is as follow:N1:106 (25.5%), N2a:100 (24%), N2b:68 (16.4%), N2c: 69 (16.6%), N3:73 (15%), respectively. The frequency of lymph node metastases according to the primary sites is as follow : larynx : 283 (28.5%), paranasal sinuses:182 (18%), oropharynx:144 (14.5%), nasopharynx:122 (12%), oral cavity:92 (9%), hypopharynx:71 (7%), salivary gland:58 (6%), unknown primary:31(3%), skin:14(2%). The most frequent primary site for the positive lymph node metastases was nasopharynx (71%) followed by hypopharynx (69%), oropharynx (64%), oral cavity (39%). The most commonhistologic type was squamous cell carcinoma (652/997: 65.4%), followed by malignant lymphoma (109/997:11%).
CONCLUSION:
Statistical results of lymph node metastases from head and neck cancer at our department were very similar to those obtained from other countries. It is concluded that the location of primary cancer influences sites of metastases on head and neck, and stage of the primary cancer also influences the development of metastatic lesions. Since the present study is limited on the data collected from one institute, further statistical analyses on Korean cancer patients are warrented.

Key Words: Head and neck cancer, Pattern of nodal metastases, Nodal status analysis