Metastatic Neck Disease

  • Tapaswani Pradhan
  • Sudhir Bahadur


An important prognostic factor in carcinoma of the larynx and hypopharynx, as indeed in other sites of the head and neck, is the presence or absence of metastatic neck disease. The factors influencing the nodal metastasis include the different subsites in the region as well as the stage of primary neoplasm (T status). Most tumours may have different biological behaviour based on the presence of neck metastasis.


  1. 1.
    Paleri V, Watkinson JC. Metastatic neck disease. In: Watkinson JC, Gilbert RW, editors. Stell and Maran’s textbook of head and neck surgery and oncology. London: Hoddar Arnold; 2011. 2012: p. 661–89.CrossRefGoogle Scholar
  2. 2.
    Byers RM, Wolf PF, Ballantyne AJ. Rationale for elective modified neck dissection. Head Neck Surg. 1988;10:160–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Kowalski LP, Medina JE. Nodal metastasis : predictive factors. Management of the neck in head and neck cancer. Otolaryngol Clin North Am. 1998;31(5):803–14.CrossRefGoogle Scholar
  4. 4.
    Canadela FC, Kothari K, Shah JP. Patterns of cervical nodal Metastasis from squamous carcinoma of the oropharynx and hypopharynx. Head Neck. 1990;12:197–203.CrossRefGoogle Scholar
  5. 5.
    Plaat RE, de Bree R, Kuik DJ, et al. Prognostic importance of paratracheal lymph node metastases. Laryngoscrope. 2005;115:894–8.CrossRefGoogle Scholar
  6. 6.
    Timon CV, Toner M, Conlon BJ. Paratracheal lymph node involvement in advanced cancer of the larynx, hypopharynx, and cervical esophagus. Laryngoscope. 2003;113:1595–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Kim JW, Roh JL, Kim JS, et al. Evaluation of 18F-FDG PET-CT and CT/MRI with histopathologic correlation in patient undergoing central compartment neck dissection for squamous cell carcinoma of the larynx, hypopharynx and oesophagus. Oral Oncol. 2013;49:449–53.PubMedCrossRefGoogle Scholar
  8. 8.
    Peters TT, Castelinjns JA, Ljumanovic R, Witte BI, Leemans CR, De Bree R. Diagnostic value of CT and MRI in the detection of paratracheal lymph nodes metastasis. Oral Oncol. 2012;48:450–5.PubMedCrossRefGoogle Scholar
  9. 9.
    Carpenter RJ, DeSanto LW. Cancer of the hypopharynx. Surg Clin North Am. 1977;57:723–35.PubMedCrossRefGoogle Scholar
  10. 10.
    EI Badawi SA, Goepfert H, Herson J, Oswald MJ. Squamous cell carcinoma of the pyriform sinus. Laryngoscope. 1982;92:357–64.Google Scholar
  11. 11.
    Stell PM. Cancer of the hypopharynx. J R Coll Surg Edinb. 1973;18:20–30.PubMedGoogle Scholar
  12. 12.
    Kraus DH, Pfister DG, Harrison LB, et al. Salvage laryngectomy for unsuccessful larynx preservation therapy. Ann Otol Rhinol Laryngol. 1995;104:936–41.PubMedCrossRefGoogle Scholar
  13. 13.
    Davidson J, Briant D, Gullane P, Keane T, Rawlinson E. The role of surgery following radiotherapy failure. A prospective study. Arch Otolaryngol Head Neck Surg. 1994;120:269–76.PubMedCrossRefGoogle Scholar
  14. 14.
    Buckley JG, Maclennan K. Cervical node metastases in laryngeal and hypopharyngeal cancer: a prospective analysis of prevalence and distribution. Head Neck. 2000;22:380–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Candela FC, Kothari K, Shah JP. Patterns of cervical node metastases from squamous cell carcinoma of the oropharynx and hypopharynx. Head Neck. 1990;12:197–203.PubMedCrossRefGoogle Scholar
  16. 16.
    Peters LJ, Goepfert H, Ang KK, et al. Evaluation of the dose for post-operative radiation therapy of head and neck cancer: first report of a prospective randomised trial. Int J Radiat Oncol Biol Phys. 1993;26:3–11.PubMedCrossRefGoogle Scholar
  17. 17.
    Newkirk KA, Cullen KJ, Harter KW, Picken CA, Sessions RB, Davidson BJ. Planned neck dissection for advanced primary head and neck malignancy treated with organ preservation therapy: disease control and survival outcomes. Head Neck. 2001;23:73–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Lecmans R, Eerenstein S, Paleri V. In: Watkins JC, Gilbert RW, editors. Neck dissection in Stell & Maran’s textbook of Head and Neck Surgery and Oncology. London: Hodder Arnold; 2012. p. 699–713.Google Scholar
  19. 19.
    Barkley HT Jr, Fletcher GH, Jesse RH, Linberg RD. Management of cervical lymph node metastases in squamous cell carcinoma of the tonsillar fossa, base of tongue, supraglottic larynx, and Hypopharynx. Am J Surg. 1972;24:762–7.Google Scholar
  20. 20.
    Ferlito A, Corry J, Silver CE, Shaha AR, Robbins KT, Rinaldo A. Planned neck dissection for patients with complete response to chemoradiotherapy: a concept approaching obsolescence. Head Neck. 2010;32:235–61.Google Scholar
  21. 21.
    Goguen LA, Posner MR, Tishler RB, Wirth LJ, Norris CM, Annino DJ, et al. Examining the need for neck dissection in the era of chemoradiation therapy for advanced head and neck cancer. Arch Otolaryngol Head Neck Surg. 2006;132:526–31.PubMedCrossRefGoogle Scholar
  22. 22.
    Stenson KM, Huo D, Blair E, Cohen EE, Argiris A, Haraf DJ, et al. Planned post-chemoradiation neck dissection : significance of radiation dose. Laryngoscope. 2006;116:33–6.PubMedCrossRefGoogle Scholar
  23. 23.
    McHam SA, Adelstein DJ, Rybicki LA, Lavertu P, Esclamado RM, Wood BG, et al. Who merits a neck dissection after definitive chemoradiotherapy for N2-N3 squamous cell head and neck cancer. Head Neck. 2003;25:791–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Dhiwakar M, Robbins KT, Vieira F, Rao K, Malone J. Selective neck dissection as an early salvage intervention for clinically persistent nodal disease following chemoradiation. Head Neck. 2012;34:188–93.PubMedCrossRefGoogle Scholar
  25. 25.
    Robbins KT, Shannon K, Vieira F. Superselective neck dissection after chemoradiation : Feasibility based on clinical and pathological comparisons. Arch Otolaryngol Head Neck Surg. 2007;133:486–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Bahadur S. Radical neck dissection. Indian J Otolaryngol Head Neck Surg. 1986;38:141–4.Google Scholar
  27. 27.
    Collins SL. Controversies in management of cancer of the neck in Thawley SE, Panje WR. In: Bataskis JG, Lindberg RD, editors. Comprehensive management of head and neck tumours. Philadelphia: WB Saunders; 1999. p. 1479–563.Google Scholar
  28. 28.
    Johnson JT, Barnes EL, Myers EN, et al. The extracapsular spread of tumour in cervical node metastasis. Arch Otolaryngol. 1981;107:725–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Ferlito A, Rinaldo A, Devaney KO, et al. Prognostic significance of microscopic and microscopic of extracapsular spread from metastatic tumour in the cervical lymph nodes. Oral Oncol. 2002;38:747–51.PubMedCrossRefGoogle Scholar
  30. 30.
    Dunne AA, Muller HH, Elsiele DW, et al. Meta-analysis of prognostic significance of perinodal spread in head and neck squamous cell carcinoma patients. Eur J Cancer. 2006;42:1863–8.PubMedCrossRefGoogle Scholar
  31. 31.
    Oosterkamp S, de Jong JM, Van den Ende PL, et al. Predictive value of lymph node metastasis and extracapsular extension for the risk of distant metastasis in laryngeal carcinoma. Laryngocope. 2006;116:2067–70.CrossRefGoogle Scholar
  32. 32.
    Bahadur S, Kumar S, Tandon DA, et al. Combined therapy in advanced head and neck cancer. J Laryngol Otol. 1992;106:243–9.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Berner K, Cooper JS, Pajak TF, et al. Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent post-operative radiation plus chemo therapy trials of the EORTC (22931) and RTOG (9501). Head Neck. 2005;L27:843–50.CrossRefGoogle Scholar
  34. 34.
    Gupta S, Bahadur S, Mathur M, Thakar A. Lateral neck dissection in cancers of the larynx and hypopharynx with No neck. Indian J Otolaryngol Head Neck Surg. 2000;52:253–6.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Lefebvre JL. Oral cavity, pharynx and larynx cancer Prognostic factors in cancer. New York: Weiley Lisa; 2001.Google Scholar
  36. 36.
    Shah J. Cervical lymph nodes. In: Shah JP, Patal S, editors. Head and neck surgery and oncology. 4th ed. Maryland Heights: Mosby; 2012: p. 353–94.Google Scholar

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© The Author(s) 2019

Authors and Affiliations

  • Tapaswani Pradhan
    • 1
  • Sudhir Bahadur
    • 2
  1. 1.Department of Surgical OncologyBLK Super Speciality HospitalDelhiIndia
  2. 2.Department of Otolaryngology and Head-Neck SurgeryFormerly at All India Institute of Medical SciencesNew DelhiIndia

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