Elective lateral neck dissection for laryngeal cancer in the clinically negative neck.
BACKGROUND
Despite the introduction of modern imaging techniques, it is still difficult to detect microscopic disease in neck nodes. The purpose of this study is to evaluate the efficacy of the lateral neck dissection (LND) for elective treatment of the clinically node negative neck (cN0) in laryngeal squamous cell carcinoma (SCC).


METHODS
The clinical records of 110 cN0 patients with laryngeal SCC treated in this hospital from January 1997 to December 2002 were reviewed retrospectively.


RESULTS
One hundred ten patients received 145 elective LND. Occult metastasis was detected in 22 (20.0%) of this group of patients. The distribution of the 37 positive nodes was as follows: Level II 56.8%; Level III 37.8%; Level IV 5.4%. The 3-year neck recurrence rate estimated by the Kaplan-Meier approach for all cN0 patients (n = 110) was 5.4% [95% CI: 0.0%; 12.5%]. No significant difference in 3-year lymph node recurrence was found between node negative and node positive groups, between supraglottis and glottis groups, or between surgery alone and combined therapy groups.


CONCLUSIONS
The lateral neck dissection is effective in elective treatment of the neck in patients with laryngeal carcinoma.
Zhang
Bin
B
Department of Head and Neck Surgery Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, PR China. docbinzhang@hotmail.com
Xu
Zhen-Gang
ZG
Tang
Ping-Zhang
PZ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D003131:Combined Modality Therapy; D017558:Elective Surgical Procedures; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate