[Correlation of cervical lymphatic metastasis to prognosis of T3-T4 glottic cancer].
OBJECTIVE
The cervical lymphatic metastasis rate of glottic cancer is low, and has seldom been reported. This study was to explore the factors related to cervical lymphatic metastasis of T3-T4 glottic cancer, and analyze its correlation to prognosis.


METHODS
Clinical data of 83 patients with T3-T4 glottic cancer, treated in Cancer Center of Sun Yat-sen University from 1992 to 2000, were reviewed retrospectively. The lymphatic metastasis rate, distribution of metastatic lymph nodes, influence factors of neck recurrence of cN0 glottic cancer, and correlation of cervical lymphatic metastasis to prognosis of T3-T4 glottic cancer were analyzed.


RESULTS
Overall lymphatic metastasis rate was 20.5%. The neck recurrence rate of cN0 patients was 14.3%. Most metastatic lymph nodes located at the ipsilateral levels II, III, and IV, while only 1 located at the contralateral level II. For cN0 patients, there was no difference in the neck recurrence rate between observation group and prophylactic cervical radiation group (P=0.772). Histopathologic differentiation affected the neck recurrence of cN0 patients (P=0.028); while T stage did not relate to the neck recurrence (P=0.217). The prognosis of cN+ patients was poorer than that of cN0 patients (P<0.001). The neck recurrence of CN0 patients did not affect the prognosis (P=0.460).


CONCLUSIONS
Most metastatic lymph nodes of T3-T4 glottic cancer locate at the ipsilateral levels II, III, and IV. Poor differentiation is significantly correlated to high risk of neck recurrence among cN0 patients. However, the recurrence does not affect the prognosis. Close observation should be done to the cervix of cN0 patients; while neck dissection should be done to cN+ patients.
Yu
Wen-Bin
WB
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China. yuwenbin429@sohu.com
Zeng
Zong-Yuan
ZY
Chen
Fu-Jin
FJ
Zhang
Quan
Q
Guo
Zhu-Ming
ZM
Li
Hao
H
Liu
Xue-Kui
XK
Wu
Guo-Hao
GH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies