Article
Prognostic significance of lymphangiosis carcinomatosa in patients with head and neck carcinoma
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Published: | August 8, 2007 |
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Introduction: Lymphangiosis carcinomatosa is a well-known prognostic factor in lung and breast carcinoma [Ref. 1]. For the head and neck cancer there are contradictory data concerning the significance of lymphangiosis carcinomatosa in cervical lymph node metastases [Ref. 2]. For example there are studies, which doubt the prognostic value of lymphangiosis carcinomatosa in the carcinoma of the head and neck [Ref. 3].
Patients and methods: We analysed 594 patients treated between 1970 and 1990, who had surgery because of a malignant tumor in the head neck region. The patients who had unilateral or bilateral cervical lymph node metastases after neck dissection were included to the study. Patients with nasal-, nasopharyngeal- and salivary gland malignancy were excluded.
Results: After histopathological exploration of the neck lymph nodes, lymphangiosis carcinomatosa could be proven in 55 patients, 539 patients had cervical lymph node metastases without lymphangiosis carcinomatosa. The 5-year survival rate was 17,6% in the first group and 48,5% in the second group (p=0,001). Additionally the incidence of lymphangiosis carcinomatosa was clearly increased with rising pN status (4% with pN1 to 16% with pN3).
Conclusion: Lymphangiosis carcinomatosa in the cervical lymph node metastases proved to be a highly significant prognostic factor for head and neck tumors. Therefore when being present, an adequate adjuvant therapy must be attached, for example simultaneous radio chemotherapy.
References
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