Comparative Examination of Preoperative FDG-PET/CT and Postoperative Pathological Findings for Advanced Hypopharynx Cancer Diagnosed as cN0

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  • Motohashi Ray
    Department of Otolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center
  • Tsukahara Kiyoaki
    Department of Otolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center
  • Sato Hiroki
    Department of Otolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center
  • Endo Minoru
    Department of Otolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center
  • Nakamura Kazuhiro
    Department of Otolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center

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Other Title
  • cN0と診断された局所進行下咽頭癌の術前FDG-PET/CTと術後病理所見の比較検討
  • cN0 ト シンダン サレタ キョクショ シンコウ カ イントウガン ノ ジュツゼン FDG-PET/CT ト ジュツゴ ビョウリ ショケン ノ ヒカク ケントウ

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Abstract

A diagnosis of cervical lymph metastasis is important for determination of treatment methods for hypopharyngeal carcinoma. Recently the usefulness of 18F-2-fluoro-2-deoxy-D-glucose-positron emission tomography combined with computed tomography (FDG-PET/CT) has been reported. We retrospectively compared postoperative histopathological findings with preoperative FDG-PET/CT findings for hypopharyngeal carcinoma patients with cN0. Fourteen patients were studied who had been diagnosed as hypopharyngeal carcinoma at the Otolaryngology/Head and Neck Surgery Department of Tokyo Medical University Hachioji Medical Center between 2009 and 2011, treated with total pharyngolaryngectomy and bilateral neck dissection, and diagnosed by FDG-PET/CT as cN0M0. Twelve patients were male and 2 were female. Ages ranged from 62 to 84, with a mean of 72. One patient was diagnosed as stage II, 7 as stage III, and 6 as stage IVA. Six of the 14 patients, i.e. 42.9%, were diagnosed as histopathologically positive for carcinoma in the cervical lymph nodes. The accuracy of the preoperative FDG-PET/CT findings was 57.1%. There were 14 lymph node metastases in 6 patients. In the lymph node metastases, the mean of the major axis was 9.1 mm, the mean of the minor axis was 6.2 mm, and the mean occupation rate of carcinoma was 59.8%. Eleven of the 14 lymph node metastases, i.e. 78.6%, were in the ipsilateral neck. We should recognize a near 40% possibility of occult neck lymph node metastasis even when hypopharyngeal carcinoma patients are diagnosed by FDG-PET/CT as cN0.

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