Critical appraisal of watchful waiting policy in the management of N0 neck of advanced laryngeal carcinoma.
OBJECTIVE
To analyze the problem of nodal recurrence of N0 neck advanced laryngeal carcinoma.


METHODS
Retrospective analysis.


METHODS
Hospital referral center.


METHODS
One hundred thirty-three patients with cancer stages T3-T4, N0, M0 who had total laryngectomy between January 1981 and December 1990.


METHODS
Nodal recurrence.


RESULTS
Of the 11 patients who had elective radical neck dissections, there was no nodal recurrence. Of the other 122 patients who had no elective neck dissection, 19 patients (16%) developed nodal recurrence and all nodal recurrence was at levels II, III, and IV. Twelve patients (63%) underwent salvage radical neck dissection for nodal recurrence and they had a 38% adjusted 5-year actuarial survival rate. Of these 122 patients who had no elective neck dissection for the N0 neck, 12 patients (10%) eventually died of nodal recurrence.


CONCLUSIONS
The watchful waiting policy is a satisfactory management option of N0 neck of advanced laryngeal carcinoma.
Yuen
A P
AP
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
Wei
W I
WI
Wong
S H
SH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D007825:Laryngectomy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016879:Salvage Therapy