A rationale for bilateral neck dissection in hypopharyngeal cancer surgery--a histological analysis of metastatic nodes in the neck.

We operated 69 patients with hypopharyngeal cancer by total laryngo-pharyngectomy and bilateral neck dissection. In order to evaluate histologically the incidence of node metastasis in ipsilateral and contralateral neck and to dis-cuss the treatment modality for latent metastasis to the cervical lymph node, extracted lymph nodes were divided into several groups of different sites of the neck and histologically examined by means of paraffin sections. The incidence of metastasis was analyzed with special reference to the site of origin, N classi-fication, T classification, histological differentiation, combinations of T classifica-tion with histological differentiation and the site of the neck. Not a few metas-tases were histologically disclosed in both ipsilateral and contralateral neck even in patients who are clinically evaluated as N0. We conclude that bilateral neck dissection is highly recommended in all cases of hypopharyngeal cancer except for only a very small number of patients with well differentiated early lesion.