End results of a prospective trial on elective lateral neck dissection vs type III modified radical neck dissection in the management of supraglottic and transglottic carcinomas

Brentani, Ricardo R.; Kowalski, Luiz Paulo; Soares, José Francisco; Torloni, Humberto; Pereira, Raimunda N.; Ikeda, Mauro Kasuo; Andrade, Roberto; Magrin, José; Miguel, Roberto E.V.; Santos, Carlos Roberto dos; Saba, L.; Salvajoli, J.V.; Curado, María Paula; Oliveira, José Carlos; Montandon, Paula O.; Machado, Márcio Martins; Denofrio, Giovana F.; Quinta, Waldyr Castro; Alvarez, Rene B.; Alencar, Rita C.G.; Oliveira, Benedito Valdecir de; Ramos, Gyl Henrique Albrecht; Antunes, Leonardo Santos; Sobrinho, Jozias Andrade; Rapoport, Abrão; Carvalho, Marcos Brasilino de; Fava, Antonio; Filho, José F. Gois; Chagas, José Francisco Salles; Kanda, Jossi Ledo; Gripp, Flávio M.; Ribas, Marcelo H.; Castro, Ivan S.; Oliveira, Joni M.S.; Oliveira, José Alberto; Carvalho, Ricardo Cruz de; Araújo, Laércio B.; Pontes, Paulo; Gregório, Luiz Carlos; Abrahão, Márcio; Cervantes, Onivaldo; Paiva, Marcos B.; Hebbel, Werner S.; Fujita, Reginaldo Raimundo; Motta, Pedro; Segreto, Roberto Araújo; Camargo, Roberto da Silva; Menten, Marcos S.; Ferreira, Eric Victor de Oliveira; Chassot, Celso Alberto

doi:10.1002/(sici)1097-0347(199912)21:8<694::aid-hed3>3.0.co;2-b

Cited by 101 publications

(2 citation statements)

References 35 publications

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“…Thus, routine elective treatment of these levels is not indicated in patients undergoing elective lymphadenectomy to remove potential occult disease among patients with laryngeal cancer and a cN0 neck. This recommendation is also supported by the results of a prospective trial that compared selective neck dissection of levels II to IV vs. modified radical neck dissection [65]. With regard to the inclusion of Level IV in elective treatment, our study found a very low rate of involvement of the nodes in this level in patients with supraglottic cancer, thus supporting the practice of not including them routinely in those cases.…”

Section: Discussionsupporting

confidence: 73%

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: Discussionsupporting

confidence: 73%

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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show abstract

“…In a prospective and randomised evaluation of T2-4N0 supraglottic and transglottic cancers no significant difference could be observed in the prognosis, locoregional recurrence rate, and complications with regard to modified radical neck dissection and selective neck dissection of level II–IV [84]. In more recent prospective investigations only selective neck dissection of level IIA and III is recommended for clinical N0 necks because of the rarely affected lymph nodes of levels IIB and IV, without impairing the oncologic result [85].…”

Section: Neck Dissection In Cases Of Clinical N0 Neckmentioning

confidence: 99%

Current advances in diagnosis and surgical treatment of lymph node metastasis in head and neck cancer

Teymoortash,

Werner

2012

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 11:Doc04; ISSN 1865-1011

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Neck Dissection: An Operation in Evolution

Myers

Gastman²

2003

Arch Otolaryngol Head Neck Surg

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End results of a prospective trial on elective lateral neck dissection vs type III modified radical neck dissection in the management of supraglottic and transglottic carcinomas

Cited by 101 publications

References 35 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

Current advances in diagnosis and surgical treatment of lymph node metastasis in head and neck cancer

Neck Dissection: An Operation in Evolution

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