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Published in: Langenbeck's Archives of Surgery 6/2014

01-08-2014 | Original Article

Micrometastasis of hypopharyngeal cancer

Authors: P. Sabljak, P. Pesko, D. Stojakov, M. Micev, E. Keramatollah, D. Velickovic, O. Skrobic, V. Sljukic, A. Djikic-Rom

Published in: Langenbeck's Archives of Surgery | Issue 6/2014

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Abstract

Purpose

The aim of this study is to estimate the incidence and clinical impact of lymph node micrometastases in hypopharyngeal squamous cell cancer (HSCC).

Materials and methods

In this retrospective study, we enrolled 58 patients who have undergone surgery for HSCC (between January 2004 and January 2011). Pharyngolaryngectomy and oesophagectomy with selective bilateral neck dissection was performed in all patients. Based on standard histological examination, 17 patients met N0 and 8 patients met N1 criteria and were further evaluated for the presence of micrometastases and isolated tumour cells (ITC). Following immunohistochemical analysis, the patients were grouped according to the presence of micrometastases and ITCs.

Results

In the pN0 group, cytokeratin-positive cells were detected in five patients, and they were marked as N0/CK+. Among these five patients, two were found to harbour micrometastases and ITCs, whilst in three, only ITCs were found. Two patients (11.75 %) were upstaged to pN1. The patients marked as N0/CK+ had a statistically significant worse overall survival rates than pN0 patients with tissue samples read as negative for cytokeratin immunostaining (p = 0.019, p < 0.05). In the pN1 group, cytokeratin-positive cells were detected in two patients, with one patient showing micrometastases and ITC, and the other showing ITC only. One patient was upstaged to pN2.

Conclusion

Patients with lymph node micrometastases and ITC had worse overall survival rates, which may indicate that more aggressive post-operative treatment regimens should be considered for these HSCC patients.
Literature
1.
go back to reference Ferlito A, Partridge M, Brennan J, Hamakawa H (2001) Lymph node micrometastases in head and neck cancer: a review. Acta Otolaryngol 121:660–665PubMedCrossRef Ferlito A, Partridge M, Brennan J, Hamakawa H (2001) Lymph node micrometastases in head and neck cancer: a review. Acta Otolaryngol 121:660–665PubMedCrossRef
3.
go back to reference Shah JP (1990) Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. Am J Surg 160:405–409PubMedCrossRef Shah JP (1990) Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. Am J Surg 160:405–409PubMedCrossRef
4.
go back to reference Don DM, Anzai Y, Lufkin RB, Fu YS, Calcaterra TC (1995) Evaluation of cervical lymph node metastases in squamous cell carcinoma of the head and neck. Laryngoscope 105:669–674PubMedCrossRef Don DM, Anzai Y, Lufkin RB, Fu YS, Calcaterra TC (1995) Evaluation of cervical lymph node metastases in squamous cell carcinoma of the head and neck. Laryngoscope 105:669–674PubMedCrossRef
5.
go back to reference Tu GY (1999) Upper neck (level II) dissection for N0 neck supraglottic carcinoma. Laryngoscope 109:467–470PubMedCrossRef Tu GY (1999) Upper neck (level II) dissection for N0 neck supraglottic carcinoma. Laryngoscope 109:467–470PubMedCrossRef
8.
go back to reference International (Ludwig) Breast Cancer Study Group (1990) Prognostic importance of occult axillary lymph node micrometastases from breast cancers. Lancet 335(8705):1565–1568 International (Ludwig) Breast Cancer Study Group (1990) Prognostic importance of occult axillary lymph node micrometastases from breast cancers. Lancet 335(8705):1565–1568
9.
go back to reference Ahmed SS, Thike AA, Iqbal J, Yong WS, Tan B, Madhukumar P, Ong KW, Ho GH, Wong CY, Tan PH (2014) Sentinel lymph nodes with isolated tumour cells and micrometastases in breast cancer: clinical relevance and prognostic significance. J Clin Pathol 67:243–250PubMedCrossRef Ahmed SS, Thike AA, Iqbal J, Yong WS, Tan B, Madhukumar P, Ong KW, Ho GH, Wong CY, Tan PH (2014) Sentinel lymph nodes with isolated tumour cells and micrometastases in breast cancer: clinical relevance and prognostic significance. J Clin Pathol 67:243–250PubMedCrossRef
10.
go back to reference Giuliano AE, McCall L, Beitsch P, Whitworth PW, Blumencranz P, Leitch AM, Saha S, Hunt KK, Morrow M, Ballman K (2010) Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg 252:426–432, discussion 423–3PubMed Giuliano AE, McCall L, Beitsch P, Whitworth PW, Blumencranz P, Leitch AM, Saha S, Hunt KK, Morrow M, Ballman K (2010) Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg 252:426–432, discussion 423–3PubMed
11.
go back to reference Hermanek P, Hutter RV, Sobin LH, Wittekind C (1999) International union against cancer. Classification of isolated tumor cells and micrometastasis. Cancer 86:2668–2673PubMedCrossRef Hermanek P, Hutter RV, Sobin LH, Wittekind C (1999) International union against cancer. Classification of isolated tumor cells and micrometastasis. Cancer 86:2668–2673PubMedCrossRef
13.
go back to reference Van den Brekel MW, van der Waal I, Meijer CJ, Freeman JL, Castelijns JA, Snow GB (1996) The incidence of micrometastases in neck dissection specimens obtained from elective neck dissections. Laryngoscope 106:987–991PubMedCrossRef Van den Brekel MW, van der Waal I, Meijer CJ, Freeman JL, Castelijns JA, Snow GB (1996) The incidence of micrometastases in neck dissection specimens obtained from elective neck dissections. Laryngoscope 106:987–991PubMedCrossRef
14.
go back to reference Ferlito A, Rinaldo A, Devaney KO, Nakashiro K, Hamakawa H (2008) Detection of lymph node micrometastases in patients with squamous carcinoma of the head and neck. Eur Arch Otorhinolaryngol 265:1147–1153. doi:10.1007/s00405-008-0715-8 PubMedCrossRef Ferlito A, Rinaldo A, Devaney KO, Nakashiro K, Hamakawa H (2008) Detection of lymph node micrometastases in patients with squamous carcinoma of the head and neck. Eur Arch Otorhinolaryngol 265:1147–1153. doi:10.​1007/​s00405-008-0715-8 PubMedCrossRef
16.
go back to reference Woolgar JA (1999) Micrometastasis in oral/oropharyngeal squamous cell carcinoma: incidence, histopathological features and clinical implications. Br J Oral Maxillofac Surg 37:181–186PubMedCrossRef Woolgar JA (1999) Micrometastasis in oral/oropharyngeal squamous cell carcinoma: incidence, histopathological features and clinical implications. Br J Oral Maxillofac Surg 37:181–186PubMedCrossRef
17.
go back to reference Fielding LP, Fenoglio-Preiser CM, Freedman LS (1992) The future of prognostic factors in outcome prediction for patients with cancer. Cancer 70:2367–2377PubMedCrossRef Fielding LP, Fenoglio-Preiser CM, Freedman LS (1992) The future of prognostic factors in outcome prediction for patients with cancer. Cancer 70:2367–2377PubMedCrossRef
19.
20.
21.
go back to reference Hamakawa H, Takemura K, Sumida T, Kayahara H, Tanioka H, Sogawa K (2000) Histological study on pN upgrading of oral cancer. Virchows Arch 437:116–121PubMedCrossRef Hamakawa H, Takemura K, Sumida T, Kayahara H, Tanioka H, Sogawa K (2000) Histological study on pN upgrading of oral cancer. Virchows Arch 437:116–121PubMedCrossRef
22.
go back to reference Gould VE, Bloom KJ, Franke WW, Warren WH, Moll R (1995) Increased numbers of cytokeratin-positive interstitial reticulum cells (CIRC) in reactive, inflammatory and neoplastic lymphadenopathies: hyperplasia or induced expression? Virchows Arch 425:617–629PubMedCrossRef Gould VE, Bloom KJ, Franke WW, Warren WH, Moll R (1995) Increased numbers of cytokeratin-positive interstitial reticulum cells (CIRC) in reactive, inflammatory and neoplastic lymphadenopathies: hyperplasia or induced expression? Virchows Arch 425:617–629PubMedCrossRef
24.
go back to reference de Boer M, van Dijck JA, Bult P, Borm GF, Tjan-Heijnen VC (2010) Breast cancer prognosis and occult lymph node metastases, isolated tumor cells, and micrometastases. J Natl Cancer Inst 102(6):410–425PubMedCrossRef de Boer M, van Dijck JA, Bult P, Borm GF, Tjan-Heijnen VC (2010) Breast cancer prognosis and occult lymph node metastases, isolated tumor cells, and micrometastases. J Natl Cancer Inst 102(6):410–425PubMedCrossRef
25.
go back to reference Li SH, Wang Z, Liu XY, Liu FY, Sun ZY, Xue H (2007) Lymph node micrometastasis: a predictor of early tumor relapse after complete resection of histologically node-negative esophageal cancer. Surg Today 37(12):1047–1052PubMedCrossRef Li SH, Wang Z, Liu XY, Liu FY, Sun ZY, Xue H (2007) Lymph node micrometastasis: a predictor of early tumor relapse after complete resection of histologically node-negative esophageal cancer. Surg Today 37(12):1047–1052PubMedCrossRef
26.
go back to reference Prenzel KL, Hölscher AH, Drebber U, Agavonova M, Gutschow CA, Bollschweiler E (2012) Prognostic impact of nodal micrometastasis in early esophageal cancer. Eur J Surg Oncol 38:314–318PubMedCrossRef Prenzel KL, Hölscher AH, Drebber U, Agavonova M, Gutschow CA, Bollschweiler E (2012) Prognostic impact of nodal micrometastasis in early esophageal cancer. Eur J Surg Oncol 38:314–318PubMedCrossRef
28.
go back to reference Nieuwenhuis EJ, Leemans CR, Kummer JA, Denkers F, Snow GB, Brakenhoff RH (2003) Assessment and clinical significance of micrometastases in lymph nodes of head and neck cancer patients detected by E48 (Ly-6D) quantitative reverse transcription-polymerase chain reaction. Lab Investig 83:1233–1240PubMedCrossRef Nieuwenhuis EJ, Leemans CR, Kummer JA, Denkers F, Snow GB, Brakenhoff RH (2003) Assessment and clinical significance of micrometastases in lymph nodes of head and neck cancer patients detected by E48 (Ly-6D) quantitative reverse transcription-polymerase chain reaction. Lab Investig 83:1233–1240PubMedCrossRef
29.
go back to reference Colnot DR, Nieuwenhuis EJ, Kuik DJ, Leemans CR, Dijkstra J, Snow GB, van Dongen GA, Brakenhoff RH (2004) Clinical significance of micrometastatic cells detected by E48 (Ly-6D) reverse transcription-polymerase chain reaction in bone marrow of head and neck cancer patients. Clin Cancer Res 10:7827–7833. doi:10.1158/1078-0432.CCR-04-1090 PubMedCrossRef Colnot DR, Nieuwenhuis EJ, Kuik DJ, Leemans CR, Dijkstra J, Snow GB, van Dongen GA, Brakenhoff RH (2004) Clinical significance of micrometastatic cells detected by E48 (Ly-6D) reverse transcription-polymerase chain reaction in bone marrow of head and neck cancer patients. Clin Cancer Res 10:7827–7833. doi:10.​1158/​1078-0432.​CCR-04-1090 PubMedCrossRef
Metadata
Title
Micrometastasis of hypopharyngeal cancer
Authors
P. Sabljak
P. Pesko
D. Stojakov
M. Micev
E. Keramatollah
D. Velickovic
O. Skrobic
V. Sljukic
A. Djikic-Rom
Publication date
01-08-2014
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 6/2014
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-014-1204-8

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