1. Current thinking on the management of abnormal retropharyngeal nodes in patients with oral, oropharyngeal, and nasopharyngeal squamous cell carcinoma: a structured review
- Author
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Anastasios Kanatas, Stergios Doumas, Charalampos Skoulakis, A. Fort-Schaale, and J. Moor
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,030218 nuclear medicine & medical imaging ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Retropharyngeal lymph nodes ,Medicine ,Humans ,Neoplasm Staging ,medicine.diagnostic_test ,business.industry ,Head and neck cancer ,Cancer ,Nasopharyngeal Neoplasms ,medicine.disease ,Magnetic Resonance Imaging ,Radiation therapy ,stomatognathic diseases ,Oropharyngeal Neoplasms ,Otorhinolaryngology ,Nasopharyngeal carcinoma ,Positron emission tomography ,030220 oncology & carcinogenesis ,Radiological weapon ,Lymphatic Metastasis ,Carcinoma, Squamous Cell ,Surgery ,Mouth Neoplasms ,Radiology ,Lymph Nodes ,Oral Surgery ,business ,Tomography, X-Ray Computed ,Neck - Abstract
The management of enlarged retropharyngeal lymph nodes (RLN) in patients with confirmed oral, oropharyngeal, or nasopharyngeal squamous cell carcinoma (SCC) has prognostic relevance and is a challenge for the clinical teams. There is, however, no consensus regarding their clinical management or radiographic evaluation. The aim of this review therefore was to present the current thinking on management to help improve outcomes. We searched several online databases using the key terms "retropharyngeal node", "oral cancer", "head and neck cancer", "oropharyngeal cancer", "nasopharyngeal cancer", "nasopharynx", "oral cavity", "oropharynx", "TORS", and "radiotherapy". A total of 1024 papers were screened, of which 32 were eligible. There was no consensus about the management of RLN. There is a lack of randomised studies and a lack of consistency in the presentation of results. Management should be tailored in patients with nasopharyngeal carcinoma (NPC), and prophylactic irradiation is warranted as these nodes are at high risk of metastasis. In patients with non-NPC tumours, we prefer to resect them during primary operations when there is radiological uncertainty or evidence that they are affected, as the combination of radiological and histological outcomes will further our understanding. In both NPC and non-NPC tumours, sampling may also help to standardise the radiological criteria for the diagnosis of RLN by contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) CT.
- Published
- 2018