Gudziol H, Beleites E
Laryngol Rhinol Otol (Stuttg). 1983 Jan;62(1):35-7.
In 348 patients with supraglottic carcinoma 154 (44%) had palpable lymph nodes. Only 26% of the patients treated surgically showed histologically abnormal nodes in the neck. The incidence of regional metastasis increased to 33% including latent lymph node metastasis. There were 4 patients (5%) with positive nodes on histologic examination which had not been detected clinically (N0). In N1- and N2-patients, histologically positive nodes were found in 41% and 29%, respectively. A fixed node (N3) was nearly always a positive node. Postoperative TNM-classification is very important in terms of prognosis of the supraglottic carcinoma. The presence of metastasis in regional lymph nodes decreased the 5-year-survival rate from 64% to 43%. Because of the high frequency of lymphatic metastases of the supraglottic carcinoma, the aim of radical surgery should include the removal of regional metastases and of the potential bilateral avenues of spread. This principle is indicated even though lymph nodes may not be palpable in partial laryngectomy.
在348例声门上型癌患者中，154例（44%）可触及淋巴结。接受手术治疗的患者中，仅26%的患者颈部淋巴结组织学检查显示异常。区域转移发生率增至33%，包括潜在的淋巴结转移。有4例患者（5%）组织学检查发现淋巴结阳性，但临床未检测到（N0）。在N1和N2期患者中，组织学检查发现阳性淋巴结的比例分别为41%和29%。固定淋巴结（N3）几乎总是阳性淋巴结。术后TNM分期对声门上型癌的预后非常重要。区域淋巴结转移的存在使5年生存率从64%降至43%。由于声门上型癌淋巴转移的发生率较高，根治性手术的目标应包括切除区域转移灶和潜在的双侧扩散途径。即使在部分喉切除术中淋巴结可能无法触及，这一原则也是适用的。
