Objectives: We evaluated the management of glottic and
supraglottic laryngeal cancers in relation to neck metastasis.
Patients and Methods: Fifty-two patients (51 males, 1
female; mean age 59.2 years; range 27 to 82 years) underwent
surgery for primary laryngeal cancers. Preoperative
and postoperative TNM classification and staging were
made according to the AJCC 1997 criteria. The mean followup
period was 39.4 months (range 6 to 74 months).
Results: The tumors were glottic in 31 patients and supraglottic
in 21 patients. Laryngectomies were partial in 34
patients and total in 18 patients. All the patients with supraglottic
tumors and those with glottic T2- 4 tumors underwent
neck dissection, as well. Radiotherapy was administered to 22
patients with established N2 or N3 tumors. Clinical assessment
was in agreement with the pathological result in 63.5%;
13.5% and 23.1% of cases were underdiagnosed and overdiagnosed,
respectively. The rates of neck metastasis were
0% in T1, 25% in T2, 75% in T3, and 66.7% in T4 supraglottic
tumors. The corresponding rates for glottic cancers were 0%,
16.7%, 28.6%, and 60%, respectively. The overall rate of N+
tumors was 28.9%. Four patients (7.7%) developed local, two
patients (3.9%) developed regional recurrences. Mortality
occurred in eight patients (15.4%) due to following causes:
laryngeal recurrence (T4N2, T4N2, T3N1), regional recurrence
( T4N2), a second primary malignancy in one patient, and other
causes in three patients. Five- and two-year disease-specific
survival rates (Kaplan-Meier analysis) were 90.7%, and overall
survival rates were 73.7% and 87.3%, respectively.
Conclusion: Neck metastasis and advanced stage of the
tumor were the most effective prognostic factors.
FREE FULL TEXTAnahtar Kelimeler: Karsinom, yassı epitel hücreli/cerrahi; larenjealneoplaziler/tanı/cerrahi; lenf nodu/patoloji; lenfatik metastaz;boyun; boyun diseksiyonu; neoplazi evrelemesi; sağkalım oranı.