title: The effect of midline crossing of lateral supraglottic cancer on contralateral cervical lymph node metastasis.
abstract: CONCLUSIONS
  The degree of midline crossing of lateral supraglottic cancer does not significantly change its rate of contralateral cervical metastasis. The rate of occult metastasis is too high to take the risk of contralateral regional recurrence. We support routine bilateral neck dissection even in lateral supraglottic cancers with no or minimal midline crossing.
  
  
  OBJECTIVE
  Data on the rate of contralateral cervical metastasis of laterally located supraglottic cancer, the effect of its degree of midline crossing on contralateral cervical metastasis, and its treatment are still controversial.
  
  
  METHODS
  This was a retrospective cohort, chart review involving 305 surgically treated patients with T1-3 squamous cell carcinoma of the supraglottic larynx. In all, 184 patients had bilateral neck dissection; 86 N0 contralateral necks were followed up. Thirty-five patients who needed postoperative radiation therapy because of the primary tumor or ipsilateral neck dissection specimen also received radiation therapy to the contralateral neck. The degree of midline crossing at the epiglottis was measured on a laryngectomy specimen with a ruler and expressed as 'no,' '<5 mm' or '≥5 mm.'
  
  
  RESULTS
  The rates of occult and overall contralateral metastasis in our series were 16% and 28%, respectively. There was no statistically significant difference between contralateral neck metastasis and recurrence rates in the neck dissection, follow-up, and irradiation groups according to the degree of midline crossing.
authors: Department of Otolaryngology-Head & Neck Surgery, Hacettepe University Faculty of Medicine , Ankara , Turkey.
authors: Taner
authors: T
authors: Yılmaz
authors: Nilda
authors: N
authors: Süslü
authors: Gamze
authors: G
authors: Atay
authors: Rıza Önder
authors: RÖ
authors: Günaydın
authors: Münir Demir
authors: MD
authors: Bajin
authors: Serdar
authors: S
authors: Özer
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Laryngeal neoplasm; larynx; lymphatic metastasis; neck; neck dissection