[The N0 neck in patients treated by supraglottic laryngectomy: abstention, surgery or radiotherapy?]

The authors examined the therapeutical approach to the N0 neck in patients submitted to supraglottic laryngectomy (SL). In these patients the choice of the therapeutical protocol may consist of simple abstention, of neck dissection or of elective radiotherapy: every decision has to be taken considering all specific inconveniences of each option. In their report the authors examined the follow-up of the N0 necks of 421 patients submitted to SL from 1970 to 1991. The patients submitted to wait and see policy were 225 whereas 196 received uni- or bilateral neck dissection. After the cervical failure's salvage the final 3-years control of the neck was the same in the two groups (91.1% vs 91.4%). In a previous research on 1157 N0 necks of patients submitted to total laryngectomy they observed a 5-years cervical control of 88.8% after wait and see policy and of 92.3% after elective radiotherapy. The conclusions of the authors is that no one of the two protocols is preferable to the other one and that subsequently in many cases of supraglottic T1 and T2 cancers a wait and see policy may be justified in absence of consistent counter-indications.