Management of the N0 neck in recurrent laryngeal squamous cell carcinoma

The most effective therapeutic approach for the node-negative (N0) neck in patients with recurrent laryngeal squamous cell carcinoma (SCC) remains a subject of dispute. In the present study, the records of 163 patients with recurrent laryngeal SCC were retrospectively reviewed. All patients had a N0 neck at recurrence. At the time of recurrence, the N0 neck was managed using a wait-and-see strategy (observation group) or treatment (treatment group). A total of 125 (76.7%) patients accepted the wait-and-see strategy and 38 (23.3%) patients underwent treatments, including surgery, radiotherapy and/or chemotherapy. The Kaplan-Meier method with the computation of log-rank was used for analysis of survival. The t-test, χ2 test or Fisher's exact test was used for comparisons of non-survival data in the groups. P<0.05 was considered to indicate a statistically significant difference in the two-sided tests. The 3- and 5-year overall survival rates after recurrence were 64.5 and 54.6% for the observation group, and 49.9 and 42.5% for the treatment group, respectively (P=0.011). The present study suggests that a wait-and-see policy is a satisfactory management option for the N0 neck in recurrent laryngeal SCC.