Prevalence and prognostic impact of retropharyngeal lymph nodes metastases in oropharyngeal squamous cell carcinoma: Meta-analysis of published literature

Head Neck. 2022 Oct;44(10):2265-2276. doi: 10.1002/hed.27166. Epub 2022 Aug 1.

Abstract

Background: This systematic review and meta-analysis aims to estimate the prevalence and prognostic impact of retropharyngeal lymph node metastases (RLNMs) in oropharyngeal squamous cell carcinoma (OPSCC).

Methods: This meta-analysis was conducted according to PRISMA guidelines.

Inclusion criteria: studies with more than 20 patients reporting the prevalence or prognostic impact of RLNMs in OPSCC. Whenever available, data on HPV status and subsites were extracted.

Results: Twenty-two articles were included. The overall prevalence of RLNMs in OPSCC was 13%, with no significant differences depending on HPV status. The highest prevalence was observed for posterior pharyngeal wall SCC (24%), followed by soft palate (17%), palatine tonsil (15%), and base of tongue (8%). RLNMs were associated with a significantly higher risk of death (HR:2.54;IC95%1.89-3.41) and progression (HR:2.44;IC95%1.80-3.30).

Conclusions: The prevalence of RLNMs in OPSCC was 13%, being higher in tumors of the posterior pharyngeal wall. RLNMs were associated with unfavorable outcomes.

Keywords: HPV; human papillomavirus; oropharyngeal cancer; retropharyngeal lymph nodes; retropharyngeal metastasis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Head and Neck Neoplasms* / pathology
  • Humans
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / pathology
  • Oropharyngeal Neoplasms* / pathology
  • Papillomavirus Infections* / complications
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / pathology