Effectiveness of Therapeutic Selective Neck Dissection in Laryngeal Cancer

• Published in: O.R.L. Journal for oto-rhino-laryngology and its related specialties Vol. 76; no. 2; pp. 89 - 97
• Main Authors: Allegra, Eugenia, Franco, Teresa, Domanico, Rossana, La Boria, Alessandro, Trapasso, Serena, Garozzo, Aldo
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2014
• Subjects: Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Effectiveness studies; Female; Head & neck cancer; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Humans; Laryngeal Neoplasms - mortality; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - surgery; Lymphatic Metastasis; Male; Middle Aged; Neck Dissection - methods; Original Paper; Retrospective Studies; Squamous Cell Carcinoma of Head and Neck; Therapy; Treatment Outcome; Selective neck dissection; Laryngeal cancer; Neck metastases; Extracapsular spread; Therapeutic neck dissection
• ISSN: 0301-1569; 1423-0275; 1423-0275
• DOI: 10.1159/000360995

Background: The aim of this study was to evaluate the effectiveness of selective neck dissection (SND) in patients with laryngeal cancer and clinically positive cervical nodes. Subjects and Methods: A retrospective review of the clinical records of 58 consecutive untreated patients affected by laryngeal carcinoma and submitted to surgical treatment was performed. Results: Twenty-six (44.8%) patients received monolateral neck dissection and 32 (55.2%) bilateral neck dissection. A total of 90 hemineck dissections were performed. Histopathological examination revealed that 25 of the 58 patients had negative nodes (pN0) and 33 had positive nodes (pN+). Extracapsular spread was found in 12 of the 33 pN+ patients. Twenty-eight of the 58 (48.2%) patients were submitted to adjuvant radiotherapy. Six of the 58 patients submitted to neck dissection had neck recurrence (rate of 10.3%). The only independent prognostic factor for neck recurrence was extracapsular spread. For the 58 patients, the 5-year overall survival was 50% and the disease-specific survival 68.9%. The 5-year disease-specific survival was 76% for pN0 patients and 63.6% for pN+ patients. Conclusions: SND can represent a therapeutic procedure because it has shown oncological results comparable to those of comprehensive neck dissection, especially when SND is combined with adjuvant radiotherapy.