[Distribution of cervical lymph node metastasis in patients with cN1 supraglottic cancer]

Abstract

Objective: To study the characteristics of the cervical lymph node metastasis of patients with cN1 supraglottic cancer and to elucidate which levels should be involved during neck dissection.

Methods: Modified neck dissections or radical neck dissections were performed for 108 cases (147 sides) of cN1 supraglottic cancer. All the lymph nodes of the samples of 147 operation sides were examined pathologically to identify the metastatic levels.

Results: Among samples of 108 cases (147 sides), 126 lymph nodes were metastasis, among which 113 lymph nodes were located in levels II and III (89.7%, 113/126), and 123 lymph nodes in levels II, III and IV (97.6%, 123/126). The 126 metastatic nodes were distributed in the 109 levels and 96 of them were in the levels II and III (88.1%, 96/109) and 106 were in the levels II, III and IV (97.2%, 106/109). Additionally, 45 cases (63 sides) of the 108 patients were pathologically metastasis (41.7%) and bilateral cervical metastasis occurred in 20 cases (18.5%). The cervical recurrent rate was 7.4% (8/108) and occurred in the levels II, III and IV respectively, during five to fourteen years follow-up.

Conclusion: Levels II, III and IV dissection may be reasonable for patients with cN1 supraglottic carcinomas, levels I and V dissection may be avoidable when pathological evidence of metastasis in levels I and V has not been obtained. Contralateral lymph node dissection at the levels II, III and IV should be performed in the case of ipsilateral pN + or contralateral metastasis cN1.