Detection of Cervical Lymph Node Micrometastases in Patients with Squamous Cell Carcinoma of the Oral Cavity, Pharynx and Larynx

Čelakovský, Petr; Kalfeřt, David; Smatanová, Katarína; Chrobok, Viktor; Laco, Jan

doi:10.14712/18059694.2015.95

Acta Medica > Archive > 2015, Vol. 58 > Issue 2 > Detection of Cervical Lymph Node…

Acta Med. 2015, 58: 62-65

https://doi.org/10.14712/18059694.2015.95

Detection of Cervical Lymph Node Micrometastases in Patients with Squamous Cell Carcinoma of the Oral Cavity, Pharynx and Larynx

Petr Čelakovský^a, David Kalfeřt^a, Katarína Smatanová^a, Viktor Chrobok^a, Jan Laco^b

^aDepartment of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic
^bThe Fingerland Department of Pathology, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic

Received April 12, 2015
Accepted June 17, 2015

Background: The goal of this prospective study was to determine the frequency of micrometastases in patients with squamous cell carcinoma (SCC) of the oral cavity, pharynx and larynx in whom elective neck dissection was indicated (cN0). Patients and Methods: A total of 12 patients (10 males and 2 females) were enrolled in the study. The age ranged 42–73 years (median 62 years). Elective neck dissection was performed in all patients (8 ipsilateral, 4 bilateral) and a total of 256 lymph nodes were removed and sent for microscopic examination. Results: The presence of tumor cells in cervical lymph nodes was found in 5/12 (42%) patients. Micrometastases of SCC were found in two patients and isolated tumor cells (ITC) in two other patients. In the remaining one patient with oropharyngeal SCC, a micrometastasis of papillary thyroid carcinoma (PTC) was detected. Positive lymph nodes were localized in level II in three patients with SCC of larynx, hypopharynx and tongue base, respectively, in level I in one patient with SCC of oral tongue and in level III in one patient with PTC. Conclusion: Our results indicate that SCC of head and neck has a high potential for creating micrometastases which frequency is higher compared to clinically detected macrometastases. Therefore, elective neck dissection or radiotherapy of the neck should be considered in patients with high risk of occult metastases or micrometastases.

Keywords

Head and neck squamous cell carcinoma, Occult metastases, Micrometastases, Isolated tumor cells.

Funding

The study was supported by the project (Ministry of Health, Czech Republic) for conceptual development of research organization 00179906 (research number 8154), by the programme PRVOUK P37/11 and by the project LM2010004.