Die prognostische Signifikanz von Kapseldurchbrüchen bei Halslymphknotenmetastasen von Plattenepithelkarzinomen*

Abstract

In a retrospective study we evaluated the clinical and histological datas of patients with squamous cell carcinomas of the head and neck to determine the influence of extranodal spread in metastases for the prognosis. Lymph nodes were dissected from the neck dissection specimens and investigated histologically with special regard to extranodal spread. 304 patients (58%) showed positive lymph nodes and 212 of this patients had additionally extranodal spread (70%). Hence, the rate of extranodal spread in the whole investigated group (522 patients) was 40%. For the patients with carcinomas of the hypopharynx the rate of extranodal spread was especially high (70%). Most extranodal spread could be found at levels 2, 3 and 4. We found a correlation between the appearance of extranodal spread and increasing T-stage. 5-year survival rates were greatly different for patients with no metastases (77%) and patients with extranodal spread (28%). We discuss the use of the criteria extranodal spread for the planning of adjuvant chemotherapy.