A clinical study of oropharynx and hypopharynx cancer with Rouvière lymph node metastasis

Patients with advanced pharyngeal carcinoma often develop metastasis to the lateral retropharyngeal lymph node（RLN; Rouvière lymph node）, but there are few reports on the treatment of RLN metastatic lesions, and no unified opinion has been reached. In this study, we reviewed 22 cases of squamous cell carcinoma of the oropharyngeal and hypopharynx that had RLN metastasis at the time of initial treatment at our hospital. Initial treatment included 11 cases of surgery and 11 cases of chemoradiotherapy. Of the patients who underwent surgery, 3 patients had RLN metastatic lesions resected and in the remaining 8 patients, RLN metastatic lesions were not resected and postoperative radiation therapy was administered. The recurrence rate of RLN was 18.2％ of all cases, and the control of RLN lesions was relatively good even in cases treated with chemoradiotherapy alone. Regardless of whether the RLN was controlled after treatment, the distant metastasis rate was especially high for hypopharyngeal cancer at 66.7％, indicating a poor prognosis. Therefore, more rigorous metastatic follow-up is required after treatment in cases of hypopharyngeal cancer.