title: Efficacy of diagnostic upper-node procedures during laryngectomy for glottic carcinoma.
abstract: BACKGROUND
  Regional recurrence of glottic squamous cell carcinoma was evaluated in patients with a clinically N0 neck who underwent selective upper-node dissection (SUND) or selective upper-node inspection (SUNI; surgical visualization and palpation of jugular lymph nodes at levels II and III) during (salvage) laryngectomy.
  
  
  METHODS
  In 152 patients, 291 clinically N0 (139 bilateral and 13 contralateral) necks were evaluated for occult neck metastases by SUNI or SUND during (salvage) laryngectomy.
  
  
  RESULTS
  Occult neck metastases were identified with SUNI or SUND in 7% of the necks (21 of 291). In 4% (n = 11) of the remaining 270 necks, regional recurrence was detected during follow-up evaluation. Thus, in these 8 patients, SUNI or SUND seemed to have failed.
  
  
  CONCLUSIONS
  SUND or SUNI of levels II and III during (salvage) laryngectomy identified the vast majority of patients who needed extensive neck treatment. In the N0 necks, these techniques led to less morbidity than elective neck dissection.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. r.pennings@kno.umcn.nl
authors.forename: Ronald J E
authors.initials: RJ
authors.lastname: Pennings
authors.forename: Henri A M
authors.initials: HA
authors.lastname: Marres
authors.forename: Annemarie
authors.initials: A
authors.lastname: den Heeten
authors.forename: Frank J A
authors.initials: FJ
authors.lastname: van den Hoogen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery*; D005260:Female; D005931:Glottis; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D007825:Laryngectomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012189:Retrospective Studies