title: Neck dissection in squamous cell carcinoma of the larynx: indication of elective contralateral neck dissection.
abstract: Unilateral or bilateral neck dissection must be considered in the treatment of laryngeal cancer
  
  
  OBJECTIVE
  To evaluate the prevalence of contralateral metastases in larynx cancer and distribution of these metastases according to lymph node levels in the neck.
  
  
  METHODS
  Retrospective longitudinal study of 272 charts from patients with squamous cell cancer of the larynx treated between 1996 and 2004; and we selected 104 surgical cases submitted to neck dissection. We evaluated the incidence of bilateral or contralateral metastases, according to the location and extension of the primary tumor, considering the anatomical sub-sites and the midline.
  
  
  RESULTS
  Contralateral metastases in lateral tumors were observed in 3.5% of glottic lesions and in 26% of supraglottic lesions. Contralateral metastases were uncommon in N0 patients. Lymph nodes levels IIa and III were the most commonly involved in the neck.
  
  
  CONCLUSIONS
  In lateral glottic tumors there is no need for elective contralateral neck dissection. In supraglottic lesions without ipsilateral metastases, the incidence of hidden metastasis does not justify elective contralateral dissection. The midline is not a reliable indicator of the risk of contralateral laryngeal tumors.
authors.affiliation: UNIFESP-Head and Neck Surgeon at the Heliópolis Hospital.
authors.forename: Ali
authors.initials: A
authors.lastname: Amar
authors.forename: Helma Maria
authors.initials: HM
authors.lastname: Chedid
authors.forename: Sergio Altino
authors.initials: SA
authors.lastname: Franzi
authors.forename: Abrão
authors.initials: A
authors.lastname: Rapoport
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008137:Longitudinal Studies; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009367:Neoplasm Staging; D012189:Retrospective Studies