[Multiple lateral cervical lymph node metastases in laryngeal carcinoma: incidence and prognostic significance]

In laryngeal oncology histological evidence of neoplastic invasion of the latero-cervical lymph nodes (N+) is considered extremely serious in terms of prognosis. To find evidence of metastasis in more than one latero-cervical lymph node is, in fact, not unusual. The purpose of the present work has been to evaluate the clinical and prognostic aspects of multiple latero-cervical metastases in a group of 440 patients suffering from laryngeal carcinoma and who had undergone either total or partial laryngectomy with mono or bilateral lymph node dissection and who had been followed up for at least three years. Of the 440 patients examined 128 (29%) proved histologically N positive and of these 71 (71/128, 55%) showed multiple lymph node metastases, even in those cases of NO. On the average, from a prognostic point of view, the presence of multiple lymph node metastases halved the NED survival rate at three years (38% vs. 65%), clinical staging being equal. In conclusion, in agreement with the literature, the present observations indicate that the number of latero-cervical lymph nodes invaded must be taken into consideration along with the common prognostic factors used in cases of laryngeal carcinoma. In fact, the presence of multiple metastases has a broad, negative affect on survival. Nonetheless, it is not yet possible and is still risky to translate multiple metastases into a preoperative prognosis.