Retropharyngeal adenopathy as a predictor of outcome in squamous cell carcinoma of the head and neck.

BACKGROUND: Little information about the incidence of retropharyngeal adenopathy and its impact on prognosis has been published.

METHODS: For 774 patients with squamous cell carcinoma of the nasopharynx, oropharynx, hypopharynx, or supraglottic larynx, pretreatment CT and, in selected cases, MRI scans were reviewed to determine the presence of retropharyngeal adenopathy. Results were analyzed in 619 patients treated with curative intent to determine the prognostic impact of retropharyngeal adenopathy.

RESULTS: The highest incidence of retropharyngeal adenopathy was seen in patients with nasopharyngeal (74%) and pharyngeal wall (19%) cancers. The number of cervical nodal groups involved was the most significant factor (p < .0001) relating to the incidence of retropharyngeal adenopathy. The rates of neck relapse (40% at 5 years) and distant metastasis were significantly higher in patients with retropharyngeal adenopathy, and the rates of 5-year relapse-free survival and absolute survival were significantly lower.

CONCLUSIONS: Retropharyngeal adenopathy is a strong predictor of poor prognosis, particularly for patients with advanced neck disease.