Retrospective study finds deep anterior invasion and larger tumor volume predict cervical lymph node metastasis in hypopharyngeal carcinoma, highlighting preoperative imaging utility.
Key Points
To evaluate whether imaging-defined deep invasion and tumor volume assessed on pretreatment CT and MRI are independently associated with clinical cervical lymph node metastasis in hypopharyngeal carcinoma.
Retrospective study of 142 consecutive patients with newly diagnosed hypopharyngeal squamous cell carcinoma who underwent pretreatment contrast-enhanced CT and MRI.
Deep anterior wall (paraglottic space) invasion was graded by contact with the superior laryngeal neurovascular bundle, deep posterior invasion was assessed on MRI, and tumor volume was measured.
Multivariable logistic regression was conducted to identify independent imaging predictors of clinical lymph node metastasis.
Clinical cervical lymph node metastasis occurred in 78 of 142 patients (54.9%), with median tumor volume significantly larger in node-positive versus node-negative tumors (3.92 vs. 0.22 cm3, P<0.001).
Deep anterior wall invasion occurred in 82 patients and was significantly more frequent in node-positive cases (73.1% vs. 39.1%, P<0.001).
Multivariable analysis identified deep anterior wall invasion (OR=2.42; 95% CI: 1.02–5.78; P=0.04) and tumor volume (OR=1.32 per cm3; 95% CI: 1.08–1.73; P=0.025) as independent factors associated with clinical lymph node metastasis.