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Dr W. I. Wei, Hong Kong, presented interesting data on the incidence of pathologic node disease in patients with primary nasopharyngeal carcinoma. Histologic serial sectioning of the operative specimens following en bloc fixation was performed on 43 patients with nasopharyngeal carcinoma who had neck dissections for clinical evidence of nodal metastases. Forty of 43 patients had pathologically positive lymph nodes; 29 had more disease than was appreciated clinically. Most of the pathologically positive lymph nodes (72.1%) were located in the upper jugular group (level II) and in the posterior triangle group (level V). Extracapsular spread of the tumor outside the lymph nodes was common (70%).
The real significance of this study is that level V lymph node metastases is common with nasopharyngeal carcinoma and that the lower part of the posterior triangle is involved. Many of the pathologically positive lymph nodes could not be detected by clinical examination, indicating that
ROBBINS KT. The Pathologic Basis of Surgery in the Management of Postradiotherapy Cervical Metastases in Nasopharyngeal Carcinoma. Arch Otolaryngol Head Neck Surg. 1991;117(11):1215. doi:10.1001/archotol.1991.01870230019003