Open AccessFactors Influencing Lymph Node Metastasis From Supraglottic Laryngeal Carcinoma
Author(s) -
Payman Dabirmoghaddam,
Nafiseh Khaksar
Publication year - 2022
Publication title -
acta medica iranica.
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.218
H-Index - 27
eISSN - 1735-9694
pISSN - 0044-6025
DOI - 10.18502/acta.v60i4.9266
Subject(s) - medicine , neck dissection , occult , pyriform sinus , metastasis , surgery , larynx , dissection (medical) , lymph node , carcinoma , lymph node metastasis , lymphatic system , cancer , radiology , pathology , fistula , alternative medicine
In patients with supraglottic carcinoma (SGLC), lymphatic metastasis is frequent and can cause a significant reduction in local control rate and survival. Currently, the preferred method of neck treatment in patients with supraglottic cancer is prophylactic bilateral neck dissection that could result in overtreatment in at least two thirds of patients. The purpose of this study is to evaluate factors influencing neck metastasis and to determine whether routine elective neck dissection is necessary for the management of all SGLCs. 66 patients with SGLCs who underwent transoral laser surgery and neck dissection were included in this study. The rate of overall and occult lymphatic involvement was 29% and 20%, respectively. The most common involvement site was level II, and factors such as T category, tumor grade, epilarynx involvement, and extension of tumor to the medial wall of pyriform sinus were significantly related to cervical lymph node metastasis. In conclusion, our results suggest that in selected patients with SGLC (such as small T1 or lateralized tumors), elective neck treatment could be ignored, and instead, close follow-up be considered.