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횡격막 아래 장기에서 발생한 악성 종양의 경부림프절 전이 사례 분석

Cervical lymph node metastasis form non-head & neck sites: below diaphragm

  • 김진일 (서울대학교병원 이비인후과) ;
  • 송슬기 (분당서울대학교병원 이비인후과) ;
  • 석준걸 (분당서울대학교병원 이비인후과) ;
  • 이민형 (서울대학교병원 이비인후과) ;
  • 한성준 (서울대학교병원 이비인후과) ;
  • 정영호 (분당서울대학교병원 이비인후과) ;
  • 안순현 (서울대학교병원 이비인후과) ;
  • 정우진 (분당서울대학교병원 이비인후과)
  • KIM, Jinil (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital) ;
  • SONG, Seulki (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital) ;
  • SEOK, Jungirl (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital) ;
  • LEE, Minhyung (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital) ;
  • HAN, Sung Jun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital) ;
  • JUNG, Young Ho (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital) ;
  • AHN, Soon Hyun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital) ;
  • JEONG, Woo-Jin (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital)
  • 투고 : 2018.08.03
  • 심사 : 2018.10.23
  • 발행 : 2018.11.30

초록

Background/Objectives: Cancers of the abdominal or pelvic organ rarely metastasize to the cervical lymph nodes. Although it indicates distant metastasis, perceivable prolongation of survival or cure may be possible in selected cases. We sought to identify patients with cervical metastasis from cancers below the diaphragm and identify patients who may benefit from aggressive treatment. Materials & Methods: From 2009 to 2017, patients with pathologically confirmed metastatic cervical lymph nodes originating from below the diaphragm were included for analysis. Patient demographics, cancer characteristics, treatment course, and clinical outcomes were analyzed. Results: 208 patients were identified. Left supraclavicular node (Virchow's node) was the most frequently involved. Irrespective of treatment, survival for uterine cervical and ovarian cancers was significantly longer than that of other primaries. Patients with isolated cervical metastasis (oligometastasis) had significantly longer median survival compared to patients with concomitant bone, lung, brain, and mediastinal metastases. Conclusion: Although cervical metastasis from cancers of the abdominal and pelvic organ represent distant metastasis, patients with uterine cervix and ovary primary and oligometastatic lesions may benefit from aggressive treatment. Prudent patient selection and further investigation is warranted.

키워드

참고문헌

  1. Feng Z, Li JN, Li CZ, Guo CB. Elective neck dissection versus observation in the management of early tongue carcinoma with clinically node-negative neck: a retrospective study of 229 cases. J Craniomaxillofac Surg. 2014;42:806-810. https://doi.org/10.1016/j.jcms.2013.11.016
  2. Lopez F, Rodrigo JP, Silver CE, Haigentz M, Jr., Bishop JA, Strojan P, et al. Cervical lymph node metastases from remote primary tumor sites. Head Neck. 2016;38 Suppl 1:E2374-2385. https://doi.org/10.1002/hed.24344
  3. Streu E. Virchow's Node and Carcinoma of Unknown Primary. Oncol Nurs Forum. 2015;42:688-690. https://doi.org/10.1188/15.ONF.688-690
  4. Ellison E, LaPuerta P, Martin SE. Supraclavicular masses: results of a series of 309 cases biopsied by fine needle aspiration. Head Neck. 1999;21:239-246. https://doi.org/10.1002/(SICI)1097-0347(199905)21:3<239::AID-HED9>3.0.CO;2-B
  5. Negus D, Edwards JM, Kinmonth JB. Filling of cervical and mediastinal nodes from the thoracic duct and the physiology of Virchow's node--studies by lymphography. Br J Surg. 1970;57:267-271. https://doi.org/10.1002/bjs.1800570407
  6. Cervin JR, Silverman JF, Loggie BW, Geisinger KR. Virchow's node revisited. Analysis with clinicopathologic correlation of 152 fine-needle aspiration biopsies of supraclavicular lymph nodes. Arch Pathol Lab Med. 1995;119:727-730.
  7. Pomel C, Jeyarajah A, Oram D, Shepherd J, Milliken D, Dauplat J, et al. Cytoreductive surgery in ovarian cancer. Cancer Imaging. 2007;7:210-215. https://doi.org/10.1102/1470-7330.2007.0030
  8. Patel MI, Beattie K, Bang A, Gurney H, Smith DP. Cytoreductive nephrectomy for metastatic renal cell carcinoma: inequities in access exist despite improved survival. Cancer Med. 2017;6:2188-2193. https://doi.org/10.1002/cam4.1137
  9. Pritchyk KM, Schiff BA, Newkirk KA, Krowiak E, Deeb ZE. Metastatic renal cell carcinoma to the head and neck. Laryngoscope. 2002;112:1598-1602. https://doi.org/10.1097/00005537-200209000-00012
  10. Lieder A, Guenzel T, Lebentrau S, Schneider C, Franzen A. Diagnostic relevance of metastatic renal cell carcinoma in the head and neck: An evaluation of 22 cases in 671 patients. Int Braz J Urol. 2017;43:202-208. https://doi.org/10.1590/s1677-5538.ibju.2015.0665