Efficacy of diagnostic upper node evaluation during (salvage) laryngectomy for supraglottic carcinoma

Authors

  • Ronald J. E. Pennings MD, PhD,

    Corresponding author
    1. Department of Otorhinolaryngology–Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
    • Department of Otorhinolaryngology–Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
    Search for more papers by this author
  • Henri A. M. Marres MD, PhD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
    Search for more papers by this author
  • Annemarie den Heeten MD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
    Search for more papers by this author
  • Frank J. A. van den Hoogen MD, PhD

    1. Department of Otorhinolaryngology–Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
    Search for more papers by this author

Abstract

Background.

The effectiveness of selective upper node dissection or inspection during laryngectomy for supraglottic squamous cell carcinoma was evaluated. These diagnostic procedures aimed to cause less morbidity than elective neck dissection in patients with a clinically N0 neck.

Methods.

In 93 patients, 166 clinically N0 necks (73 bilateral and 20 contralateral) were evaluated. Lymph nodes at levels II and III were inspected or dissected and directly sent in for frozen section histopathology. This way, occult neck metastases were identified and treated by neck dissection.

Results.

Occult neck metastases were identified in 19% of the examined necks (31/166). Regional recurrence rate in the postoperative N0 necks was 0%, and 10% in the postoperative N+ necks.

Conclusions.

Selective upper node dissection and inspection during laryngectomy reduced the need for an elective neck dissection with its morbidity in the clinically N0 neck. In addition, it selects the patients who need such extensive treatment. © 2008 Wiley Periodicals, Inc. Head Neck, 2009.

Ancillary