The risk of contralateral lymphatic metastases for cancers of the larynx and pharynx.
OBJECTIVE
This study was undertaken to determine the risk of cervical metastases to the contralateral side in patients treated for carcinoma of the larynx and pharynx.


METHODS
Retrospective evaluation of 846 patients treated between 1962 and 1981 with carcinoma of the supraglottis, transglottis, and pyriform sinus were reviewed. Lesions were classified as either transglottic with fixed vocal cord (TG-F), transglottic with mobile vocal cords (TG-M), central supraglottic (SG-C), marginal supraglottic (SG-M), glossoepiglottic cancers of the suprahyoid epiglottic, vallecula, and tongue base (SG-GE), and cancers of the pyriform sinus (PS).


RESULTS
Contralateral lymph node metastases were identified at presentation or later developed in SG-GE 26%, SG-M 14%, PS 13%, SG-C 7%, TG 4%. Contralateral metastases were significantly higher in patients with ipsilateral metastasis. The risk of contralateral metastasis was unrelated to the primary tumor size.


CONCLUSIONS
All but 79 patients received variable doses of irradiation to the contralateral neck. Therefore, the risk of metastatic disease is probably higher than reported. Parotid-sparing radiation technique is suggested for centrally located cancers of the supraglottis and transglottis when ipsilateral nodes are not involved because the risk of contralateral neck involvement is sufficiently low that opposite neck irradiation may be safely avoided.
Marks
J E
JE
Department of Radiotherapy, Loyola University of Chicago, Stritch School of Medicine, Maywood, IL 60153.
Devineni
V R
VR
Harvey
J
J
Sessions
D G
DG
D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009333:Neck; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome