ArticleTherapeutic advances in medical oncology2025
The association between level IV/V metastasis and the recurrence, distant metastasis, and survival outcomes in hypopharyngeal squamous cell carcinoma.
Article in Therapeutic advances in medical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Efficacy and Safety of Induction Chemotherapy Followed by Concurrent Chemoradiotherapy in Locoregionally Advanced Hypopharyngeal Carcinoma.Advances in radiation oncology · 2026Article
- Lower-neck involvement and post-concurrent chemoradiotherapy response predict distant metastasis in head and neck cancer.Radiation oncology journal · 2026Article
- Primary small cell neuroendocrine carcinoma of the tonsil combined with squamous cell carcinoma of the hypopharynx: a case report.AME case reports · 2026Article
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6 authors.
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Abstract
Background: The presence of level IV/V metastasis is a significant prognostic factor for patients with oral and oropharyngeal cancer, while level IV lymphadenopathy defines the N3 stage in nasopharyngeal carcinoma. However, the current staging system for hypopharyngeal squamous cell carcinoma (HPSCC) does not consider the location of involved nodes. Objectives: To evaluate the risk factors and prognostic impact of level IV/V metastasis in patients with HPSCC. Methods: The analysis included 2740 HPSCC patients from the SEER (Surveillance, Epidemiology, and End Results) database, followed by a validated study on 232 patients with pathologically positive nodes (pN+) at our center. Results: Of the 2740 patients, 1961 presented with metastatic lymph nodes (LNs), 20.8% and 14.1% had nodal involvement in level IV and level V, respectively. Multivariate analysis revealed that N3 and M1 stages were independently associated with level IV/V metastasis. Level IV metastasis was the sole independent adverse factor for overall survival (OS) among all LN regions ( Conclusion: Metastasis to level IV/V was associated with a worse prognosis in HPSCC patients. The level IV/V should be considered for future improvements to the staging system. Design: A retrospective study.
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