Cervical metastasis on level IV in laryngeal cancer.
The presence of cervical metastasis has substantial negative impact on survival of patients with laryngeal cancer. Bilateral elective selective neck dissection of levels II, III and IV is usually the chosen approach in these patients. However, there is significant morbidity associated with level IV dissection, such as phrenic nerve injury and lymphatic fistula. The objective of the present study was to evaluate the frequency of metastatic nodes in level IV in clinically T3/T4N0 patients with laryngeal cancer. The pathological reports of 77 patients with clinically T3/T4N0 laryngeal squamous cell carcinoma were reviewed. Patients underwent bilateral lateral neck dissection from January 2007 to November 2012. The surgical specimens were subdivided in levels before evaluation. There were 12 patients with neck metastasis (15.58%). In 3 cases (3.89%), there were metastatic lymph nodes in level IV, all T4 and with ipsilateral metastasis. In conclusion, the incidence of level IV metastasis was 3.89%, an in all patients was staged as T4.
São Paulo School of Medicine, University of São Paulo, Brazil;
V J
VJ
Furtado de Araújo Neto
Department of Head and Neck Surgery, São Paulo School of Medicine, University of São Paulo, Brazil;
C R
CR
Cernea
Department of Head and Neck Surgery, Hospital das Clínicas, Group of Laryngeal and Hypopharyngeal Tumors, Department of Head and Neck Surgery, Hospital das Clínicas, São Paulo School of Medicine, University of São Paulo, Brazil.
R
R
Aparecido Dedivitis
Department of Head and Neck Surgery, São Paulo School of Medicine, University of São Paulo, Brazil;
V J
VJ
Furtado de Araújo Filho
São Paulo School of Medicine, University of São Paulo, Brazil;
J
J
Fabiano Palazzo
Department of Head and Neck Surgery, São Paulo School of Medicine, University of São Paulo, Brazil;
L
L
Garcia Brandão
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; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D009367:Neoplasm Staging
Laryngeal neoplasms; Lymphatic metastasis; Neck dissection; Neoplasm staging; Squamous cell carcinoma