[Incidence of regional metastasis in supraglottic carcinoma]

In 348 patients with supraglottic carcinoma 154 (44%) had palpable lymph nodes. Only 26% of the patients treated surgically showed histologically abnormal nodes in the neck. The incidence of regional metastasis increased to 33% including latent lymph node metastasis. There were 4 patients (5%) with positive nodes on histologic examination which had not been detected clinically (N0). In N1- and N2-patients, histologically positive nodes were found in 41% and 29%, respectively. A fixed node (N3) was nearly always a positive node. Postoperative TNM-classification is very important in terms of prognosis of the supraglottic carcinoma. The presence of metastasis in regional lymph nodes decreased the 5-year-survival rate from 64% to 43%. Because of the high frequency of lymphatic metastases of the supraglottic carcinoma, the aim of radical surgery should include the removal of regional metastases and of the potential bilateral avenues of spread. This principle is indicated even though lymph nodes may not be palpable in partial laryngectomy.