title: Factors contributing to lymph node occult metastasis in supraglottic laryngeal carcinoma cT2-T4 N0M0 and metastasis predictive equation.
abstract: OBJECTIVE
  To investigate factors that contribute to lymph node metastasis (LNM) from clinical cT2-T4 N0M0 (cN0) supraglottic laryngeal carcinoma (SLC), and to predict the risk of occult metastasis before surgery.
  
  
  METHODS
  A total of 121 patients who received surgery were retrospectively analyzed. Relevant factors regarding cervical LNM were analyzed. Multivariate analyses were conducted to predict the region where the metastasis occurred and prognosis.
  
  
  RESULTS
  The overall metastatic rate of cN0 SLC was 28.1%. Metastatic rates were 15.4%, 32.5% and 35.7% for T2, T3 and T4, respectively. Metastatic rates for SLC levels II, III and IV were 19.6%, 17.2% and 3.6%, respectively. A regression equation was formulated to predict the probability of metastasis in cN0 SLC as follows: Pn=e((-3.874+0.749T3+1.154T4+1.935P1+1.750P2))/[1+e((-3.874+0.749T3+1.154T4+1.935P1+1.750P2))]. Approximately 0.2% of patients experienced LNM with no recurrence of laryngeal cancer. Comparison of the intergroup survival curves between patients with and without LNM indicated a statistically significant difference (P=0.029).
  
  
  CONCLUSIONS
  Cervical lymph node metastatic rates tended to increase in tandem with T stage in patients with LNM in cN0 SLC, and neck dissection is advised for these patients. Moreover, cervical LNM in cN0 SLC showed a sequential pattern and may be predicted.
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China.
authors.forename: Hongzhi
authors.initials: H
authors.lastname: Ma
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Lian
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Feng
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China.
authors.forename: Pingdong
authors.initials: P
authors.lastname: Li
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China.
authors.forename: Lizhen
authors.initials: L
authors.lastname: Hou
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Chen
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Huang
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2 Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otorhinolaryngology, Beijing 100005, China ; 3 Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China.
authors.forename: Jugao
authors.initials: J
authors.lastname: Fang
keywords: Larynx; lymph nodes; neoplasm metastasis; prediction