Clinically Detected Nodal Metastases Upon Admission Based on T Stage

Primary Site

 T Stage

 N0, %

 N1, %

 N2-N3, %

Oral tongue

T1

86

10

4

 

T2

70

19

11

 

T3

52

16

31

 

T4

24

10

66

Floor of mouth

T1

89

 9

2

 

T2

71

18

10

 

T3

56

20

24

 

T4

46

10

43

Retromolar trigone/anterior tonsillar pillar

T1

88

2

9

 

T2

62

18

20

 

T3

46

21

33

 

T4

32

18

50

Soft palate

T1

92

0

8

 

T2

64

12

24

 

T3

35

26

39

 

T4

33

11

56

Tonsillar fossa

T1

30

41

30

 

T2

32

14

54

 

T3

30

18

52

 

T4

10

13

76

Base of tongue

T1

30

15

55

 

T2

29

14

56

 

T3

26

23

52

 

T4

16

8

76

Oropharyngeal walls

T1

75

0

25

 

T2

70

10

20

 

T3

33

22

44

 

T4

24

24

52

Supraglottic larynx

T1

61

10

29

 

T2

58

16

26

 

T3

36

25

40

 

T4

41

18

41

Hypopharynx

T1

37

21

42

 

T2

30

20

49

 

T3

21

26

54

 

T4

26

15

58

Nasopharynx

T1

8

11

82

 

T2

16

12

72

 

T3

12

9

80

 

T4

17

6

78

Incidence of Positive Retropharyngeal Nodes for Various Primary Sites and Clinical Neck Stages (794 Tumors)

   
      Clinical Neck Stage
Primary Site   

N0 Neck

N+† Neck

 

Overall

Nasopharynx   

2/5 (40%)

12/14 (86%)

 

74%

Pharyngeal wall   

6/37 (16%)

12/56 (21%)

 

19%

Soft palate  

1/21 (5%)

6/32 (19%)

 

13%

Tonsillar region  

2/56 (4%)

14/120 (12%)

 

9%

Pyriform sinus or postcricoid area  

0/55 (0%)

7/81 (9%)

 

5%

Base of tongue  

0/31 (0%)

5/90 (6%)

 

4%

Supraglottic larynx  

0/87 (0%)

4/109 (4%)

 

2%

Failure of Initial Ipsilateral Neck Treatment: 596 Patients with Carcinoma of the Tonsillar Fossa, Base of Tongue, Supraglottic Larynx, or Hypopharynx

 

N0

Treatment

No Treatment

Partial  Treatment 

Complete Treatment

N1

N2a

N2b

N3a

N3b

Irradiation

0%

15%

2%

15%

27%

27%

38%

34%

Surgery 

55%

35%

7%

11%

8%

23%

42%

41%

Combined

– 

20%

0%

0%

0%

0%

23%

25%

Five-Year Rate of Neck Control by 1983 AJCC Stage and Treatment (459 Patients; 593 Heminecks)

  Radiotherapy Alone

Radiotherapy Plus Neck Dissection

 
Stage

No. of Heminecks

Control

No. of Heminecks

Control

Significance

N1

215

86%

38

93%

P = .28

N2a 29

79%

24

68%

P = .6

N2b

138

70%

80

91%

P <.01

N3a

29

33%

40

69%

P <.01

Cervical Metastasis Appearing in the Contralateral N0 Neck: 596 Patients with Carcinoma of the Tonsillar Fossa, Base of Tongue, Supraglottic Larynx, or Hypopharynx

 

 Stage 

Treatment

N0

N1

N2a

N2b

N3a

Irradiation 

4%

2%

9%

7%

0%

Surgery

25%

17%

23%

43%

33%

Combined

0%

0%

0%

11%

0%

            Metastatic Cervical Lymph Nodes, Unknown Primary Site 3-Year Disease-Free Absolute Survival Rates

 

 Type of Treatment

Stage 

Surgery 

Radiation Therapy

Combination Therapy

NX

31/39 (79%)

8/9 (89%)

3/3 (100%)

N1

4/6 (67%)

1/3 (33%)

1/3 (33%)

N2

10/22 (45%)

3/4 (75%)

5/9 (55%)

N3

14/37 (38%)

13/36 (36%)

4/13 (31%)

Total

59/104* (57%)

25/52† (48%)

13/28† (46%)