O Gallo1, I Fini-Storchi, L Napolitano. 1. Institute of Otorhinolaryngology Head & Neck Surgery, University of Florence, Italy. o.gallo@dfc.unifi.it
Abstract
BACKGROUND: Elective treatment of the contralateral N0 neck in supraglottic cancer patients with unilateral metastases is controversial. METHODS: We reviewed 127 N1-3 cases with contralateral negative necks to compare elective contralateral dissection (ED: 24 cases) with a contralateral wait-and-see policy (WS: 103 cases) and subsequent delayed therapy (SDT: 40 cases) when contralateral disease became evident. Prognostic factors were studied to identify the risk of contralateral disease. RESULTS: Nine of 24 (37.5%) ED patients had occult contralateral metastases, and 40 of 103 (38.8%) WS patients had a delayed contralateral failure. Supraglottic cancers involving or extending up to the midline had a higher risk of contralateral metastases compared with well-lateralized tumors (p =.049). The risk of contralateral neck disease was more influenced by tumor site and stage than by histopathologic characteristics of ipsilateral metastases. WS patients with contralateral neck relapse showed a higher risk of distant metastases and of level I and V neck involvement than ED cases with no difference in terms of survival. CONCLUSIONS: The risk of contralateral occult neck involvement in supraglottic laryngeal cancers with unilateral metastases is high (about 40%), particularly for more advanced lesions extending to or involving the midline larynx; thus, a bilateral neck treatment in such cases is recommended. Copyright 2000 John Wiley & Sons, Inc.
BACKGROUND: Elective treatment of the contralateral N0 neck in supraglottic cancerpatients with unilateral metastases is controversial. METHODS: We reviewed 127 N1-3 cases with contralateral negative necks to compare elective contralateral dissection (ED: 24 cases) with a contralateral wait-and-see policy (WS: 103 cases) and subsequent delayed therapy (SDT: 40 cases) when contralateral disease became evident. Prognostic factors were studied to identify the risk of contralateral disease. RESULTS: Nine of 24 (37.5%) ED patients had occult contralateral metastases, and 40 of 103 (38.8%) WSpatients had a delayed contralateral failure. Supraglottic cancers involving or extending up to the midline had a higher risk of contralateral metastases compared with well-lateralized tumors (p =.049). The risk of contralateral neck disease was more influenced by tumor site and stage than by histopathologic characteristics of ipsilateral metastases. WSpatients with contralateral neck relapse showed a higher risk of distant metastases and of level I and V neck involvement than ED cases with no difference in terms of survival. CONCLUSIONS: The risk of contralateral occult neck involvement in supraglottic laryngeal cancers with unilateral metastases is high (about 40%), particularly for more advanced lesions extending to or involving the midline larynx; thus, a bilateral neck treatment in such cases is recommended. Copyright 2000 John Wiley & Sons, Inc.
Authors: Soon-Hyun Ahn; Hyun Jun Hong; Soon Young Kwon; Kee Hwan Kwon; Jong-Lyel Roh; Junsun Ryu; Jun Hee Park; Seung-Kuk Baek; Guk Haeng Lee; Sei Young Lee; Jin Choon Lee; Man Ki Chung; Young Hoon Joo; Yong Bae Ji; Jeong Hun Hah; Minsu Kwon; Young Min Park; Chang Myeon Song; Sung-Chan Shin; Chang Hwan Ryu; Doh Young Lee; Young Chan Lee; Jae Won Chang; Ha Min Jeong; Jae-Keun Cho; Wonjae Cha; Byung Joon Chun; Ik Joon Choi; Hyo Geun Choi; Kang Dae Lee Journal: Clin Exp Otorhinolaryngol Date: 2017-01-03 Impact factor: 3.372