title: Occult lymph node metastasis in laryngeal squamous cell carcinoma: therapeutic and prognostic impact.
abstract: OBJECTIVE
  To assess the incidence and impact on treatment and prognosis of occult lymph node metastasis in laryngeal cancer.
  
  
  METHODS
  A retrospective study was performed on 164 patients treated for laryngeal cancer, initially classified as N0, with cervical lymph node dissection.
  
  
  RESULTS
  Occult metastases were found in 41 neck specimens (12.5%) from 32 patients (19.5%). Involvement per neck level was: 7% level IIa, 2.4% IIb, 4.2% III and 2.7% IV. Lymph node involvement was significantly increased in case of T3T4 tumor or invasion of the pre-epiglottic space or cartilage. Survival was significantly influenced by pN status (pN- = 12 years, vs pN+ = 9 years; P = 0.006).
  
  
  CONCLUSIONS
  Level IIb or IV involvement is rare. Superselective neck dissection (IIa, III) seems to be indicated in T1T2 N0 tumor. In case of advanced tumor or pre-epiglottic space or cartilage invasion, functional neck dissection is mandatory.
authors.affiliation: Service ORL et chirurgie cervicofaciale, CHU Habib Bourguiba, 3029 Sfax, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Mnejja
authors.forename: B
authors.initials: B
authors.lastname: Hammami
authors.forename: L
authors.initials: L
authors.lastname: Bougacha
authors.forename: A
authors.initials: A
authors.lastname: Chakroun
authors.forename: I
authors.initials: I
authors.lastname: Charfeddine
authors.forename: A
authors.initials: A
authors.lastname: Khabir
authors.forename: T
authors.initials: T
authors.lastname: Boudaoura
authors.forename: A
authors.initials: A
authors.lastname: Ghorbel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011379:Prognosis; D012189:Retrospective Studies