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Rational choice of neck dissection in clinically N0 patients with supraglottic cancer
Ye Zhang1, Siyuan Xu2, Wensheng Liu2
1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
Background:
The mainstay treatment of the neck for clinically negative neck (cN0) supraglottic laryngeal carcinoma (SGLC) is neck dissection. However, the optimal extent remains controversial. This study's purpose is to determine whether ipsilateral level II-III neck dissection is appropriate for cN0SGLC patients.
Methods:
The records of 220 consecutive untreated cN0SGLC patients were retrospectively reviewed. Relevant factors related to occult and contralateral neck metastasis were analyzed and the distribution of metastasis was described.
Results:
Seventy-seven and 143 patients underwent unilateral and bilateral neck dissection, respectively. The rate of occult neck metastases was 21.4%. The histologic differentiation was an independent risk factor for occult neck metastasis. In the bilateral neck dissection group, the incidence of contralateral neck metastasis of patients with noncentral tumors was 0.7%. Moreover, only 1.7% of patients had positive nodes at level IV, and no isolated nodal metastases existed in level IV.
Conclusion:
Ipsilateral level II-III neck dissection is feasible for patients with noncentral cN0SGLC.
