Occult Metastatic Rate of Laryngeal Cancer Predicted by Elective Neck Dissection

Korean Journal of Head & Neck Oncology 2004;20(1):19-23.
Published online May 30, 2004.

Kyung Tae;Jin Seok Jeong;Dong Wook Lee;Jin Hyeok Jeong;Hyung Seok Lee

후두암종에서 예방적 경부청소술로 확인한 경부 잠재전이율

태경;정진석;이동욱;정진혁;이형석

Abstract

Background and Objectives: Neck metastasis is one of the most important prognostic factor in head and neck squamous cell carcinoma. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal cancer varies widely depending upon authors. To evaluate the rate and characteristics of occult metastasis and efficacy of the elective neck dissection in clinical N0 laryngeal cancer, we performed this study. Materials and Method: Seventy two patients (supraglottic cancer: 19 cases, glottic cancer: 53 cases) who underwent surgery for laryngeal cancer as an initial treatment from 1993 to 2002 were evaluated. All was underwent elective neck dissection at the time of surgery for the primary treatment. The record of patients and pathologic report were reviewed retrospectively.
Results
Occult metastasis rate of supraglottic and glottic cancer were 42.1% (8/19) and 9.4% (5/53), respectively. According to T stage, the occult meastasis of supraglottic and glottic cancer was 20%, 0% in T1, 36.4%, 0% in T2, 100%, 40% in T2, 100%, 20% in T4, respectively. Occult metastasis was mostly confined within level II (69.2%), III (76.9%), IV (23.1%).
Conclusion
Based on ours results, elective neck dissection might be needed in treating of clinically N0 all supraglottic cancer and advanced T3, T4 glottic cancer.

Key Words: Larynx cancer, Lymphatic metastasis, Lymph node dissection