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Rational choice of neck dissection in clinically N0 patients with supraglottic cancer
Author(s) -
Zhang Ye,
Xu Siyuan,
Liu Wensheng,
Wang Xiaolei,
Wang Kai,
Liu Shaoyan,
Xu Zhengang,
Liu Jie
Publication year - 2020
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26014
Subject(s) - medicine , neck dissection , occult , metastasis , surgery , dissection (medical) , incidence (geometry) , radiology , carcinoma , cancer , pathology , alternative medicine , physics , optics
Background The mainstay treatment of the neck for clinically negative neck (cN0) supraglottic laryngeal carcinoma (SGLC) is neck dissection. However, the optimal extent remains controversial. This study's purpose is to determine whether ipsilateral level II‐III neck dissection is appropriate for cN0SGLC patients. Methods The records of 220 consecutive untreated cN0SGLC patients were retrospectively reviewed. Relevant factors related to occult and contralateral neck metastasis were analyzed and the distribution of metastasis was described. Results Seventy‐seven and 143 patients underwent unilateral and bilateral neck dissection, respectively. The rate of occult neck metastases was 21.4%. The histologic differentiation was an independent risk factor for occult neck metastasis. In the bilateral neck dissection group, the incidence of contralateral neck metastasis of patients with noncentral tumors was 0.7%. Moreover, only 1.7% of patients had positive nodes at level IV, and no isolated nodal metastases existed in level IV. Conclusion Ipsilateral level II‐III neck dissection is feasible for patients with noncentral cN0SGLC.