Rate of Occult Cervical Lymph Node Involvement in Supraglottic Squamous Cell Carcinoma

Document Type : Original

Authors

Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Introduction:
To assess the rate of cervical lymph node involvement in patients with supraglottic squamous cell carcinoma (SCC) with no lymph node in clinical assessments and radiological studies.
Materials and Methods:
Fifty-six patients who underwent elective dissection of the cervical lymph node of the second through fourth level were enrolled, and pathologic evaluation of the dissected lymph nodes was performed. Lymph node involvement and association between tumor grade, smoking and gender with lymph node involvement were assessed.
Results:
The rate of the occult neck metastasis in this series was 37.5%. There was no statistically significant association between lymph node involvement and tumor grade, smoking, or gender.
Conclusion:
Based on the results of our study, we recommend elective bilateral neck dissection in all stages of N0 supraglottic SCC patients.

Keywords

Main Subjects


1. De Stefani E, et al. Supraglottic and glottic carcinomas: epidemiologically distinct entities? Int J Cancer Journal 2004;112:1065–71.
2. Hoffman HT, et al. Laryngeal cancer in the United States: changes in demographics, patterns of care, and survival. The Laryngoscope 2006;116:1–13.
3. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin 2007;57:43–66.
4. Menvielle G, Luce D, Goldberg P, Bugel I, Leclerc A. Smoking, alcohol drinking and cancer risk for various sites of the larynx and hypopharynx. A case-control study in France. Eur J Cancer Prevent 2004;13:165–72.
5. Candela FC, Shah J, Jaques DP, Shah JP. Patterns of cervical node metastases from squamous carcinoma of the larynx. Arch Otolaryngol Head Neck Surg 1990;116:432–5.
6. Esposito ED, Motta S, Cassiano B, Motta G. Occult lymph node metastases in supraglottic cancers of the larynx. Otolaryngol Head Neck Surg 2001; 124:253–7.
7. Gallo O, Fini-Storchi I, Napolitano L. Treatment of the contralateral negative neck in supraglottic cancer patients with unilateral node metastases (N1-3). Head Neck 2000;22:386–92.
8. Spriano G, Piantanida R, Pellini R, Muscatello L. Elective treatment of the neck in squamous cell carcinoma of the larynx: clinical experience. Head Neck 2003; 25:97–102.
9. Deganello A, Gitti G, Meccariello G, Parrinello G, Mannelli G, Gallo O. Effectiveness and pitfalls of elective neck dissection in N0 laryngeal cancer. Acta Otorhinolaryngol Ital 2011;31:216–21.
10. Hicks WL, et al. Patterns of nodal metastasis and surgical management of the neck in supraglottic laryngeal carcinoma. Otolaryngol Head Neck Surg 1999; 121: 57–61.
11. Redaelli de Zinis LO, et al. The distribution of lymph node metastases in supraglottic squamous cell carcinoma: therapeutic implications. Head Neck 2002;24:913–20.
12. Ali S, Tiwari RM, Snow GB. False-positive and false-negative neck nodes. Head Neck Surg 1985;8:78–82.
13. Cagli S, Yuce I, Yigitbasi OG, Güney E.Is routine bilateral neck dissection absolutely necessary in the management of N0 neck in patients with supraglottic carcinoma? Eur Arch Otorhinolaryngol 2007;264:1453–7.