[Cervical lymph node metastasis and recurrence in supraglottic carcinoma after operation].

OBJECTIVE

To evaluate the regional control efficacy of elective neck dissection (END) in patients with supraglottic carcinoma.

METHODS

The incidence of cervical recurrences of 582 patients with supraglottic carcinoma treated in this hospital from 1981 to 1993 were retrospectively reviewed.

RESULTS

Three hundred and ninety-two cases (67.35%) of this group had T3 and T4 primary lesions. Among them, 147 cases (37.50%) had positive nodes(N+) and this accounted for 86.47% (147/170) of all N+ patients. Ipsilateral or bilateral cervical recurrence occurred in 33 of 126 (26.19%) node negative (N0) cases who had not had neck dissection and 30 of them (90.90%) were among T3 and T4 groups. However, Contralateral lymph node recurrence occurred only in 40 of 286(13.99%) N0 cases who had had END and 30 of them (75%) were among T3 and T4 groups. There were 163 cases who were readmitted and received surgery again for different purposes. The three and five year survival rates in the second stage END group were 86.67% and 77.78%, in metastasis group 64.81% and 32.50%, in recurrent group 33.33% and 30.77% respectively. There were significant differences in survival rates among these groups.

CONCLUSION

Patients underwent elective neck dissection achieved better survival than those on "wait and watch" policy and salvage surgery. Elective neck dissection is recommended for the treatment of supraglottic carcinoma, especially for the T3 and T4 diseases.