Prognostic Significance of Extracapsular Spread in Metastatic Lymph Node of Head and Neck Squamous Cell Carcinoma / 대한이비인후과학회지

ABSTRACT

BACKGROUND: Lymph node metastasis in head and neck squamous cell carcinoma has been interpretated as a poor prognostic factor. However, N staging system which depends on the size and numbers of the metastatic lymph node has been reported to be insufficient as a prognostic factor. OBJECTIVES: To determine the value of extracapsular spread of metastatic lymph node as a prognostic factor and to evaluate the relationship of extracapsular spread and N staging system of metastatic lymph node. MATERIALS AND METHODS: From January 1990 to December 1993, 109 patients who received neck dissection for metastatic lymph node of head and neck squamous cell carcinoma were retrospectively studied for the presence of extracapsular spread according to N staging and compared the survival rates between the N staging system and the presence of extracapsular spread. RESULTS: Histopathologically, there were 17 cases(15.6%) of N0, 56 cases(51.4%) of N1, 25 cases(22.9%) of N2, and 11 cases(10.1%) of N3. Extracapsular spread in N1 was 30.4%, 64.0% in N2, and 90.9% in N3. Three year overall survival rate for N0 was 58%, 69% for N1, 48% for N2, 27% for N3, and 69% for 49 cases without extracapsular spread and 46% in 43 cases with extracapsular spread. CONCLUSION: Presence of extracapsular spread in metastatic lymph node of head and neck squamous cell carcinoma seems to have a significant value as a prognostic factor.