Significance of retropharyngeal node dissection at radical surgery for carcinoma of the hypopharynx and cervical esophagus

Objectives: To clarify the efficacy of dissection of retropharyngeal lymph nodes (RPLNs) in the surgical treatment of carcinoma of the hypopharynx and cervical esophagus, Study Design: We started planned dissection of the RPL N during initial radical surgery in patients with squamous cell carcinoma o f the hypopharynx or the cervical esophagus in 1988, Until 1997, we perform ed this procedure as a standard operation in 82 consecutive patients. Metho ds: Mortality resulting from RPLN metastasis was compared between 82 patien ts who underwent RPLN dissection and 69 patients who did not undergo the pr ocedure. Results: Of 82 patients, 16 patients (20%) had positive RPLNs, The se patients were at high risk of recurrence unless the node(s) were dissect ed. Although RPLN dissection did not improve the cumulative B-year survival rate, it significantly decreased the number of patients who died of RPLN m etastasis (chi (2) = 3.68, P < ,1), Four of the 16 patients who had positiv e RPLNs survived without any recurrence. Conclusion: Bilateral dissection o f the RPLN during initial surgery is highly recommended in every surgical c ase of carcinoma of the hypopharynx and cervical esophagus.