Abstract
We investigated the cervial metastatic pattern of a series of 89 hypopharyngeal and cervical esophageal cancer patients. The five-year accumulative survival rate among this group was 55%. The correlation between N classification and the five-year survival rate was as follows ; N 0 (30 cases) :70%, N 1 (16 cases) :58%, N 2 a (14 cases) :39%, N 2 b (16 cases) :49%, N 2 c (8 cases) : 58%, and N 3 (5 cases) : 25%. The most frequently involved site was the mid-jugular chain followed by the superior jugular chain, the inferior jugular chain, and the occipital triangle lymph nodes. In seven patients, the metastatic lymph node was located at the contralateral side of the primary lesion. Bilateral modified neck dissection with the preservation of internal jugular vein was employed as a routine surgical option for the metastasized lymph nodes . Post-surgical pathology examination (pN) revealed 54% of the lymph node specimen was positively involved by cancer. Thirty-seven N positive patients were treated with radiation therapy without surgical intervention. Among them, 18 patients with successfully controlled . In 10 patients, cervical lymph node metastasis was identified at the time of patients' demise. We concluded that our good treatment result was due to the high percentage of the successfully controlled N positive cases.
