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

Abstract

Objectives: We aimed to assess the associations between localization, size, stage and histopathological differentiation of primary tumor in larynx and neck metastases and the impact of disease stage on survival. Materials and methods:We analyzed the medical records of 333 laryngeal cancer patients who underwent total or partial laryngectomy as primary treatment, combined with neck dissection and/or postoperative radiotheraphy if required, between 2000 and 2010 years at our clinic. Age and gender of patients, tumor localization, size, stage and histopathological differentiation of tumor; presence of preoperative positive lymph nodes, performed operations, operation findings and histopathological results were analysed retrospectively. Results:Tumor localizations were glottic in 172 (51.6%) cases, supraglottic in 108 (32.4%), and transglottic 53 (15.9%) of the the cases. In glottic cancers; cervical metastases were observed in 18.6% of the patients, whereas occult metastases in 11%. In supraglottic cancers; cervical metastasis rate was 45.3% and occult metastases rate was 24%. In transglottic cancers, cervical metastases rate was 49% and occult metastases was 22.6%. Postoperative recurrence was 41 (12.3%). Postoperative radiotherapy was recommended to 111 of 333 patients. The overall survival rate was 75.4% at 50th month and the cumulative survival rate was 68.9%. Conclusion:In conclusion, although there is controversy regarding the optimal treatment in the N0 larynx cancers, in case of a high risk for occult metastases, elective unilateral or bilateral neck dissection should be performed according to the anatomic localization of the tumor. In addition, survival rate decreased significantly with the increasing tumor stage. J Clin Exp Invest 2012; 3(2): 214-222Key words: Larynx cancer, localization, stage, cervical lymph node metastases, survival ÖZET Amaç: Çalışmamızda larenkste tespit edilen primer tümörün lokalizasyonu, büyüklüğü, evresi, histopatolojik diferansiasyon derecesi, tutmuş olduğu anatomik yapı ile boyun metastazı arasındaki ilişkisi ve tümörün evresinin sağkalım üzerine olan etkisini araştırdık. Gereç ve yöntem:Kliniğimizde 2000-2010 yılları arasında larenks kanseri nedeniyle primer tedavi olarak cerrahi (total veya parsiyel larenjektomi) uygulanmış olan, gerektiğinde boyun diseksiyonu yapılan ve gerektiğinde postoperatif radyoterapi uygulanan 333 hastanın dosyaları incelendi. Hastaların yaşı, cinsiyeti, tümörün lokalizasyonu, tümörün büyük-lüğü, tümörün evresi, histopatolojik diferansiasyon derecesi, preoperatif pozitif lenf nodu bulunup bulunmadığı, yapılan ameliyatlar, ameliyat bulguları ve postop spesmenin histopatolojik değerlendirme sonuçları retrospektif olarak incelendi. Bulgular: Tümörün yerleşim bölgesine göre; vakaların 172'si (%51.6) glottik, 108'i (%32.4) supraglottik, 53'ü (%15.9) ise transglottik yerleşimliydi. Glottik tümörlerde %18.6 oranında servikal metastaz, %11 oranında occult metastaz tespit edilirken, supraglottik tümörlerde %45.3 oranında servikal metastaz, %24 oranında...

Assessment of Dimensional Changes in Submandibular Glands in Head–Neck Radiotherapy Patients by Ultrasonography

“…Likewise, in the present study, 21 (91.3%) of the 23 patients planned to receive head and neck radiotherapy were male and only 2 (8.7%) were female, with the mean age of 54.3 years. Although the mean age of patients included in this study is lower than that of patients included in other previous studies, the sex distribution is comparable 4,30–34 …”

“…Although the mean age of patients included in this study is lower than that of patients included in other previous studies, the sex distribution is comparable. 4,[30][31][32][33][34] The incidence of head and neck cancer types varies according to anatomical regions. 2,13,31,35 According the 2008 statistics published by GLOBOCAN, 35 the esophagus is the leading site of head and neck cancer worldwide, followed by the thyroid gland, non-Hodgkin lymphoma, lips or oral cavity, larynx, nasopharynx, oropharynx, hypopharynx, Hodgkin lymphoma, and salivary glands.…”

“…According to the global cancer incidence data published by GLOBOCAN in 2012 4 and 2018, 31 the incidence of esophageal cancer is 3 to 4 times higher in males than in females, that of nasopharyngeal cancer is 2 to 3 times higher in males than in females, and that of thyroid cancer is 3 times higher in females than in males. Şengül et al 32 and Raitiola et al 33 reported that only 3%–5% patients with laryngeal cancer were female. Moreover, the distribution of head and neck cancers varies with age, and this malignancy is common in individuals at 50–70 years of age 30 .…”