The management of glottic and supraglottic cancers of the larynx in relation to neck metastasis.
OBJECTIVE
We evaluated the management of glottic and supraglottic laryngeal cancers in relation to neck metastasis.


METHODS
Fifty-two patients (51 males, 1 female; mean age 59.2 years; range 27 to 82 years) underwent surgery for primary laryngeal cancers. Preoperative and postoperative TNM classification and staging were made according to the AJCC 1997 criteria. The mean follow-up period was 39.4 months (range 6 to 74 months).


RESULTS
The tumors were glottic in 31 patients and supraglottic in 21 patients. Laryngectomies were partial in 34 patients and total in 18 patients. All the patients with supraglottic tumors and those with glottic T2-4 tumors underwent neck dissection, as well. Radiotherapy was administered to 22 patients with established N2 or N3 tumors. Clinical assessment was in agreement with the pathological result in 63.5%; 13.5% and 23.1% of cases were underdiagnosed and overdiagnosed, respectively. The rates of neck metastasis were 0% in T1, 25% in T2, 75% in T3, and 66.7% in T4 supraglottic tumors. The corresponding rates for glottic cancers were 0%, 16.7%, 28.6%, and 60%, respectively. The overall rate of N+ tumors was 28.9%. Four patients (7.7%) developed local, two patients (3.9%) developed regional recurrences. Mortality occurred in eight patients (15.4%) due to following causes: laryngeal recurrence (T4N2, T4N2, T3N1), regional recurrence (T4N2), a second primary malignancy in one patient, and other causes in three patients. Five- and two-year disease-specific survival rates (Kaplan-Meier analysis) were 90.7%, and overall survival rates were 73.7% and 87.3%, respectively.


CONCLUSIONS
Neck metastasis and advanced stage of the tumor were the most effective prognostic factors.
Yücetürk
Ali Vefa
AV
Department of Otolaryngology, Medicine Faculty of Celal Bayar University, Manisa, Turkey. alivefayuceturk@yahoo.com
Celik
Onur
O
Eskiizmir
Görkem
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000556:secondary / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005931:Glottis / Q000473:pathology; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy / Q000706:statistics & numerical data; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000601:surgery; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D014421:Turkey / Q000453:epidemiology