Abstract
The treatment strategy for retropharyngeal lymph node metastasis is discussed. The surgical anatomy and pitfalls in surgical approaches to the retropharyngeal space are demonstrated. The incidence of retropharyngeal node metastasis in hypopharyngeal cancer varies from 5 % to over 50% depending on the institution. At Tokyo University, it is estimated to occur in about 7 % of all patients and in over 10% of the cases at Stage N or with N stage over N2b. These results indicate that the resection of retropharyngeal nodes is recommended only when the metastasis is confirmed by CT or MR imaging before surgery. From the standpoint of post-operative QOL, prophylactic resection is only suitable in those cases with Stage N diseases.
