Levels II and III neck dissection for larynx cancer with N0 neck

Chone, Carlos Takahiro; Kohler, Hugo Fontana; Magalhães, Rodrigo; Navarro, Marcos; Altemani, Albina; Crespo, Agrício Nubiato

doi:10.5935/1808-8694.20120009

Cited by 7 publications

(10 citation statements)

References 17 publications

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“…All the studies were case series, except the case control study by Djordjevic et al [45]. Eight studies were prospective [20,25,27,29,36,39,42,45]; fifteen studies analyzed the larynx without specification of occult metastasis by subsite [10,13,15,20,[24][25][26][27]29,34,37,39,40,43,46]; nineteen analyzed supraglottic tumors [10,12,14,16,18,19,22,23,28,[30][31][32][33]35,36,38,42,44,45]; and six, glottic tumors [10,17,21,23,31,41]. Katilmis et al included a small number of hypopharynx tumors (13/213)…”

Section: Resultsmentioning

confidence: 99%

“…All studies, except two [34,39], reported an overall rate of occult metastasis of 18.7% (711/3803 patients). The pooled incidence was not calculated due to the expected clinical and statistical heterogeneity by subsites.…”

Section: Rate Of Occult Metastasismentioning

confidence: 99%

“…In total, 1643 patients were classified as T1-2 and 1785 as T3-4. In two studies (366 patients) it was impossible to obtain data on clinical stage [24,39]. Regarding treatment, 852 patients underwent partial laryngectomy while 675 had total laryngectomy.…”

Section: Description Of Patients Included In the Studiesmentioning

confidence: 99%

“…Regarding treatment, 852 patients underwent partial laryngectomy while 675 had total laryngectomy. Thirteen studies did not report the surgical procedure done for the primary tumor [10,24,25,27,28,[31][32][33]37,39,40,43,45]. CS: case series; CC: case control; G: glottis; LNOS: larynx, not otherwise specified; NR: not reported; P: prospective; R: retrospective; S: supraglottis.…”

Section: Description Of Patients Included In the Studiesmentioning

confidence: 99%

“…The presence of occult lymph node metastasis at level I was reported in only two studies [10,13], but in both there was no information about involvement of sublevels IA or IB. Level II involvement was reported in eleven studies [10,13,24,27,29,[32][33][34][44][45][46], level III in eleven studies, [10,13,24,27,29,[32][33][34][44][45][46], level IV in seventeen studies [10,13,20,[24][25][26][27]29,[32][33][34]37,39,[43][44][45][46] and level V in five studies [10,13,20,24,34]. Figures S4, S5 and Table S1 shows data about the studies and pooled incidence and…”

Section: Occult Metastasis By Lymph Node Levelmentioning

confidence: 99%

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Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level: A Systematic Review

Sanábria

Shah

Medina

et al. 2020

Cancers

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Background: Larynx cancer is a common site for tumors of the upper aerodigestive tract. In cases with a clinically negative neck, the indications for an elective neck treatment are still debated. The objective is to define the prevalence of occult metastasis based on the subsite of the primary tumor, T classification and neck node levels involved. Methods: All studies included provided the rate of occult metastases in cN0 larynx squamous cell carcinoma patients. The main outcome was the incidence of occult metastasis. The pooled incidence was calculated with random effects analysis. Results: 36 studies with 3803 patients fulfilled the criteria. The incidence of lymph node metastases for supraglottic and glottic tumors was 19.9% (95% CI 16.4–23.4) and 8.0% (95% CI 2.7–13.3), respectively. The incidence of occult metastasis for level I, level IV and level V was 2.4% (95% CI 0–6.1%), 2.0% (95% CI 0.9–3.1) and 0.4% (95% CI 0–1.0%), respectively. For all tumors, the incidence for sublevel IIB was 0.5% (95% CI 0–1.3). Conclusions: The incidence of occult lymph node metastasis is higher in supraglottic and T3–4 tumors. Level I and V and sublevel IIB should not be routinely included in the elective neck treatment of cN0 laryngeal cancer and, in addition, level IV should not be routinely included in cases of supraglottic tumors.

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Section: Resultsmentioning

confidence: 99%

Section: Rate Of Occult Metastasismentioning

confidence: 99%

Section: Description Of Patients Included In the Studiesmentioning

confidence: 99%

Section: Description Of Patients Included In the Studiesmentioning

confidence: 99%

Section: Occult Metastasis By Lymph Node Levelmentioning

confidence: 99%

See 3 more Smart Citations

Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level: A Systematic Review

Sanábria

Shah

Medina

et al. 2020

Cancers

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Role of Neck Dissection in Organ-Preservation for Glottic Squamous Cell Carcinoma

Ortíz

Reynoso-Noverón

Zacarias-Ramon

et al. 2021

Indian J Otolaryngol Head Neck Surg

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Lymph Node Involvement in T1a Glottic Carcinoma: Controversial Case Series

Yalçınozan

Şafak

2020

Asian Journal of Oncology

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The treatment modality of laryngeal cancer is complete resection of the primary lesion and dissection of the cervical lymph nodes that is related to their staging. Following the patient without neck dissection is the usual expectation in T1 glottic carcinomas. However, a combination of elective neck dissection with surgical treatment for clinically N0 neck in early glottic tumors may be an effective treatment modality in the prevention of missed micrometastases. In these two case reports, elective neck dissection and re-examination of the treatment were discussed accordingly. We aimed to point out the importance of evaluation, examination, and, if it is uncertain, moreover the dissection of lymph nodes in early-stage glottic carcinoma since there are rarely any studies available.

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Levels II and III neck dissection for larynx cancer with N0 neck

Abstract: The prevalence rate for lymph node metastasis in cN0 necks was 0%. Level IV metastatic lymph nodes were correlated to cN (+) necks. Level IV metastasis was associated with the presence of metastatic lymph nodes in levels II or III.

Cited by 7 publications

References 17 publications

Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level: A Systematic Review

Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level: A Systematic Review

Role of Neck Dissection in Organ-Preservation for Glottic Squamous Cell Carcinoma

Lymph Node Involvement in T1a Glottic Carcinoma: Controversial Case Series

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