RETROPHARYNGEAL ADENOPATHY AS A PREDICTOR OF OUTCOME IN SQUAMOUS-CELLCARCINOMA OF THE HEAD AND NECK

Background. Little information about the incidence of retropharyngeal adenopathy and its impact on prognosis has been published. Methods. Fo r 774 patients with squamous cell carcinoma of the nasopharynx, oropha rynx, hypopharynx, or supraglottic larynx, pretreatment CT and, in sel ected cases, MRI scans were reviewed to determine the presence of retr opharyngeal adenopathy. Results were analyzed in 619 patients treated with curative intent to determine the prognostic impact of retropharyn geal adenopathy. Results. The highest incidence of retropharyngeal ade nopathy was seen in patients with nasopharyngeal (74%) and pharyngeal wall (19%) cancers. The number of cervical nodal groups involved was t he most significant factor (p < .0001) relating to the incidence of re tropharyngeal adenopathy. The rates of neck relapse (40% at 5 years) a nd distant metastasis were significantly higher in patients with retro pharyngeal adenopathy, and the rates of 5-year relapse-free survival a nd absolute survival were significantly lower. Conclusions. Retrophary ngeal adenopathy is a strong predictor of poor prognosis, particularly for patients with advanced neck disease. (C) 1995 John Wiley and Sons , Inc.