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Upper neck (level II) dissection for N0 neck supraglottic carcinoma.
1Department of Head and Neck Surgery, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical University, Beijing, China. TUJUN@PUBLIC3.BTA.NET.CN
The Laryngoscope
|March 25, 1999
Summary
For N0 supraglottic laryngeal cancer, a comprehensive neck dissection is unnecessary. Selective neck dissection, such as upper neck dissection (UND), effectively manages the neck and achieves comparable survival rates.
Area of Science:
- Head and Neck Surgery
- Surgical Oncology
- Laryngeal Cancer Research
Background:
- Elective neck dissection for N0 neck in head and neck surgery remains controversial.
- Determining optimal neck management for N0 supraglottic carcinoma is crucial.
Purpose of the Study:
- To evaluate the efficacy of selective neck dissection for N0 supraglottic laryngeal cancer.
- To identify an appropriate neck management strategy for this patient group.
Main Methods:
- A prospective nonrandomized study involving 142 patients with T1-4N0M0 supraglottic laryngeal cancer.
- Upper neck dissection (UND) was performed, with lymph nodes sent for frozen section analysis.
- Patients were observed for at least 5 years for neck recurrences and survival rates.
Main Results:
- All 142 UND specimens were negative for metastasis.
- The 5-year survival rate was 80.8%.
- Neck recurrences occurred in 10.6% of patients within 5 years, comparable to rates after radical or modified neck dissections.
Conclusions:
- Comprehensive neck dissection is not required for N0 supraglottic laryngeal cancer.
- Selective neck dissection, including UND (level II) or supraomohyoid neck dissection (levels II and III), is sufficient for radical treatment.
- This approach offers effective neck management while potentially reducing morbidity.