[Significance of neck dissection during salvage laryngectomy for patients of recurrence after radiotherapy].

OBJECTIVE

To evaluate the rate of occult metastases detected with elective neck dissection during salvage laryngectomy for patients of recurrence after radiotherapy. The relationship between occult metastases and tumor stage, complications and survival rate after operation was analyzed.

METHOD

Retrospective review of 24 laryngo-carcinoma patients recurrent after radiotherapy treated with salvage surgery and 28 patients directly received laryngectomy in our hospital between 2005 and 2008.

RESULT

A higher risk of occult metastases was noted in patients of recurrence after radiotherapy than those without radiation therapy. Cartilage invasion and perineural invasion in the larynx were associated with a higher risk of occult metastases. A statistically significant difference of survival advantage was not noted between these two groups.

CONCLUSION

We recommend bilateral neck dissection at the time of laryngectomy for recurrent staged T3/4 tumors and all patients with recurrent glottis and supraglottic cancers because of the higher rate of occult metastases.