[The study on the occult metastases to cervical lymph node in squamous cell carcinoma of the larynx and hypopharynx]

Abstract

Objective: To study the metastastic regularity of cervical lymph node in squamous cell carcinoma of the larynx and hypopharynx, which will provide some theoretical basis for surgeon to use selective neck dissection (SND) in some patients with carcinoma above.

Method: Sixty-nine originally cN0 staged neck dissection specimens from 40 patients were evaluated using mutipl-level sectioning in 4 microns intervals, which were respectively processed by H&E-staining and immunostaining with an antibody to cytokeratin (CK AE3). These patients weren't given any treatment (radiotherapy or chemotherapy or surgery in neck) before surgery. All cases had been followed up 1 year or more.

Result: The examination of lymph nodes from 40 patients revealed 31 (0.59% 31/2219) occult metastases in 14 (35% 14/40) patients. Among them, six patients with supraglottic cancer, 1 patient with transglottic cancer and 7 patients with hypopharyngeal cancer. There were no occult metastases to cervical lymph node among 9 patients with glottic cancer. All occult metastases mainly located in ipsilateral level II and/or level III. Occult metastases weren't found in nodes from level I, level IV and level V.

Conclusion: The study further prove that metastases to cervical lymph node mainly occur in the ipsilateral level II and level III among patients with carcinoma of the larynx and hypopharynx. According to the risks of occurring occult metastases to cervical lymph node, we suggest applying to ipsilateral or bilateral SND (level II and level III be dissected) among patients with carcinoma of the larynx and hypopharynx which staged T2-T4 N0M0 clinically.