Factors influencing contralateral metastasis and prognosis from pyriform sinus carcinoma

Background: The presence of neck metastasis reduces the probability of regional control and survival. The purpose of this study is to identify risk factors for contralateral neck metastasis in a series of 218 patients with pyriform sinus carcinoma. Patients and methods: Tumor stages were: 31 T1–T2, 187 T3–T4, 40 N0, 174 N1–N3, and 4 NX. A total of 182 patients (83%) had metastatic lymph nodes (23 in the contralateral neck). Results: Thirty-five patients presented neck recurrences (27 in contralateral undissected neck). Logistic regression identified T and N stages, epilarynx and posterior pharyngeal wall involvement, hemilarynx fixation, and ipsilateral level 1 metastasis as important predictors of contralateral metastasis. Five-year survival rates were 41% (pN0), 23% (contralateral pN0), and 31% (contralateral positive nodes). Conclusions: The contralateral side of the neck was the most common site of recurrence. A lateral neck dissection is advisable for the contralateral side of the neck for high-risk patients.