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Prognostic value of Delphian lymph node in T1b glottic carcinoma
Lorenzo Pignataro1, Andrea Peri, Davide Pagani
1Clinica Otorinolaringoiatrica, Dipartimento di Science Otorinolaringologiche, Ospedale Maggiore di Milano, Policlinico, IRCCS, University of Milan, Via Francesco Sforza 35, 20122 Milano, Italy. lorenzo.pignataro@unimi.it
Background:
The published papers concerning Delphian lymph node (DN) involvement in laryngeal tumours generally consider advanced laryngeal and hypopharyngeal cancer. We investigated the role of DN in a selected group of patients with T1b glottic squamous cell carcinoma.
Materials And Methods:
The study involved 53 patients with T1b glottic squamous cell carcinoma who underwent horizontal glottectomy. DN was isolated in 46 (86.8%). Histological evaluation of the isolated nodes revealed the presence of metastases in three cases (6.5%).
Results:
Forty-six of the 53 patients (86.8%) are still alive and disease-free; four (7.5%) died because of their disease and three (5.7%) because of unrelated causes. The 3- and 5-year overall survival was, respectively, 94.3% and 90.6%. Both the 3- and 5-year disease-free survival was 92.5%. Two of the three patients with a metastatic DN died because of a recurrence: laterocervical lymph node metastases in one case and parastomal recurrence in the other. The frequency of local relapse was at the threshold of significance in the patients with a positive DN (p = 0.0540). Of the four patients who died of their disease, two were DN-positive. Mortality was statistically higher in the DN-positive patients (p = 0.0166).
Conclusion:
The presence of DN metastases was statistically associated with recurrence and overall survival in T1b glottic cancer.