Factors Influencing Regional Lymph Node Metastasis from Laryngeal Carcinoma

Abstract

A series of 103 cases of laryngeal carcinoma subjected either to a unilateral or to a bilateral comprehensive neck dissection was reviewed with reference to risk factors influencing regional lymph node metastasis. The sensitivity of clinical examination was only 67.4%, while the specificity was 88.3%. Most metastases were in the upper and middle jugular chain of nodes (levels 2 and 3). Only patients with positive nodes at levels 2, 3, and/or 4 had histologically positive nodes at levels 1 or 5. Selected demographic, clinical, and pathologic variables were analyzed with respect to their potential predictive value regarding the risk of histologically proven neck node metastasis. Logistic regression analysis demonstrated that tumor site and histologic grade were the most important predictors of lymph node metastasis. Considering only NO cases, the likelihood of occult metastasis was significantly affected exclusively by tumor site (higher risk for supraglottic lesions).

Treatment results, side effects and prognostic factors affecting survival in patients with larynx cancer

“…The incidence of neck-lymph node metastasis in glottic cancers is below 10%, while it ranges between 10-50% in supraglottic cancers. [16][17][18] Raitiola et al demonstrated that both regions showed differences in their T stages, and stated that supraglottic cancers had significantly higher T stages. In this study, glottic, and supraglottic localizations were observed in 53%, and 47% of the patients, respectively.…”

The relationship between the frequency of cervical metastases and tumor related factors in laryngeal cancer and outcome of surgical treatment in these cases

“…6,8 Glottik kanserlerde servikal metastaz oranları %10'un altında iken supraglottik kanserlerde bu oranın %20 -50 arasında değiştiği bildirilmiştir. 10,11,14 Zengin lenfatik vaskülarizasyondan dolayı ve bazen de kötü diferansiasyona bağlı olarak supraglottik kanserler, erken evrelerde bile sıklıkla klinik olarak tespit edilebilen bölgesel boyun metastazıyla karşımıza gelebilmektedir.…”

“…17 Bizim çalışmamızdaki 108 supraglottik kanserli vakanın 49'unda (%45.3) ipsilateral servikal metastaz, 25 vakada (%23) ise occult metastaz saptandı. Kowalski ve arkadaşları, 6 yaptığı çalışmada, transglottik tümörlerde servikal metastaz oranını %41 olarak rapor etmişlerdir. Baş-ka bir çalışmada, transglottik tümörlerde servikal metastaz oranı %32 olarak bulunmuş ve 4 cm'den büyük transglottik tümörlerde ise %55 oranında servikal metastaz bildirilmiştir.…”

Current Concept of Selective Nek Dissection

“…This basic knowledge provides a basis for planning of neck dissection in relation to the primary tumor. Lateral neck dissection (SND II-IV) has been used widely in the past twenty years for management of the neck in clinically N0 laryngeal cancer because it has been demonstrated that metastases of laryngeal cancer usually occurs in these levels and levels I and V are rarely involved (Robbins, 2002, Kowalski, 1995, Jones, 1994. SND II-IV is very effective in treating occult metastases and in a previous study from the author of this chapter's department, it has been demonstrated that a neck recurrence rate as low as 1.7% can be achieved after SND II-IV (Erisen, 2001).…”