Skip to main content

Predictors of extracapsular spread in lymph node metastasis

Abstract

We investigated effect of clinical and pathologic parameters on extracapsular spread (ECS) in patients with lymph node metastasis in laryngeal and hypopharyngeal cancer. About 186 patients and 342 neck dissection were included in this study. Relationship between ECS and tumor location, T stage, pathologic N stage, tumor differentiation, number of metastatic lymph nodes, diameter of metastatic lymph node and impact of presence ECS on contralateral neck metastasis (CNM) were evaluated; 76 of the 186 patients had lymph node metastasis. Of the 76 patients, 31 (40.7%) had ECS. Tumor location, pathologic N stage of the tumor, number of metastatic lymph nodes, diameter of metastatic lymph node and the presence of CNM were significantly associated with ECS (P < 0.05). Only number of (≥3) lymph node metastasis emerged as significant independent predictor of ECS (P < 0.05; OR:11.6). In conclusion, the number of metastatic lymph nodes (≥3) should be used as predictor of ECS. Furthermore, contralateral neck dissection should be performed in patients with ipsilateral lymph node metastasis with ECS.

This is a preview of subscription content, access via your institution.

References

  1. Byers RM, Wolf PF, Ballantyne AJ (1998) Rationale for elective modified neck dissection. Head Neck Surg 10:160–167

    Article  Google Scholar 

  2. Hirabayashi H, Koshii K, Uno K et al (1991) Extracapsular spread of squamous cell carcinoma in neck lymph nodes: prognostic factor of laryngeal cancer. Laryngoscope 101:502–506

    PubMed  Article  CAS  Google Scholar 

  3. Puri SK, Fan CY, Hanna E (2003) Significance of extracapsular lymph node metastases in patients with head and neck squamous cell carcinoma. Curr Opin Otolaryngol Head Neck Surg 11:119–123

    PubMed  Article  Google Scholar 

  4. Snow GB, Annyas AA, Van Slooten EA. Bartelink H, Hart AA (1982) Prognostic factors of neck node metastasis. Clin Otolaryngol 7:185–192

    PubMed  Article  CAS  Google Scholar 

  5. Olsen KD, Caruso M, Foote RL et al (1994) Primary head and neck cancer. Histopathologic predictors of recurrence after neck dissection in parients with lymph node involvement Arch Otolaryngol Head Neck Surg 120:1370–1374

    PubMed  CAS  Google Scholar 

  6. Morales-Angulo C, Val-Bernal F, Buelta L, Fernandez F, Garcia-Castrillo L, Rama J (1998) Prognostic factors in supraglottic laryngeal carcinoma. Otolaryngol Head Neck Surg 119:548–553

    PubMed  Article  CAS  Google Scholar 

  7. De Zinis LO, Bolzoni A, Piazza C, Nicolai P (2006) Prevalence and localization of nodal metastases in squamous cell carcinoma of the oral cavity: role and extension of neck dissection. Eur Arch Otorhinolaryngol 263:1131–1135

    PubMed  Article  Google Scholar 

  8. Prim MP, De Diego JI, Hardisson D et al (1999) Extracapsular spread and and desmoplastic pattern in neck lymph nodes: two prognostic factors of laryngeal cancer. Ann Otol Rhinol Laryngol 108:672–676

    PubMed  CAS  Google Scholar 

  9. Brasilino de Carvalho M, Cole I, Hughes L (1998) Quantitative analysis of the extent of extracapsular invasion and its prognostic significance: a prospective study of 170 cases of carcinoma of the larynx and hypopharynx. Head Neck 20:16–21

    Article  Google Scholar 

  10. Vaidya AM, Petruzzelli GJ, Clark J et al (2001) Patterns of spread in recurrent head and neck squamous cell carcinoma. Otolaryngol Head Neck Surg 125:393–396

    PubMed  Article  CAS  Google Scholar 

  11. Alvi A,Johnson JT (1996) Extracapsular spread in the clinically negative neck (NO): implications and outcome. Otolaryngol Head Neck Surg 114:65–70

    PubMed  Article  CAS  Google Scholar 

  12. Coatesworth AP, Maclennan K (2002) Squamous cell carcinoma of the upper aerodigestive tract: the prevalence of microscopic extracapsular spread and soft tissue deposits in the clinically N0 neck. Head Neck 24:258–261

    PubMed  Article  Google Scholar 

  13. Liu B, Guan C, Ji WY, Pan ZM (2002) Extracapsular spread in ipsilateral neck metastasis: an important factor in laryngeal cancer. Chin Med Sci J 21:86–89

    Google Scholar 

  14. Suoglu Y, Erdamar B, Katırcıoglu OS, Karatay MC, Sunay T (2002) Extracapsular spread in ipsilateral neck and contralateral neck metastases in laryngeal cancer. Ann Otol Rhinol Laryngol 111:447–454

    PubMed  Google Scholar 

  15. Schuller DE, Bier-Laning CM (1997) Laryngeal carcinoma nodal metastases and their management. Otolaryngol Clin North Am 30:167–177

    PubMed  CAS  Google Scholar 

  16. Gallo O, Fini-Storchi I, Napolitano L (2000) Treatment of the contralateral negative neck in supraglottic cancer patients with unilateral node metastases (N1–3). Head Neck 22:386–392

    PubMed  Article  CAS  Google Scholar 

  17. Kowalski LP, Franco EL, de Andrade Sobrinho J (1995) Factors influencing regional lymph node metastasis from laryngeal carcinoma. Ann Otol Rhinol Laryngol 104:442–447

    PubMed  CAS  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Ercan Pinar.

Additional information

Presented at 6th European Congress of Oto-Rhino-Laryngology Head and Neck Surgery, 30th June–4th July 2007, Vienna, Austria.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Imre, K., Pinar, E., Oncel, S. et al. Predictors of extracapsular spread in lymph node metastasis. Eur Arch Otorhinolaryngol 265, 337–339 (2008). https://doi.org/10.1007/s00405-007-0464-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-007-0464-0

Keywords

  • Extracapsular spread
  • Lymph node metastasis
  • Laryngeal cancer