ABSTRACT
BACKGROUND AND OBJECTIVES: The status of cervical lymph node is a great influence to the prognosis of patient with head and neck cancer. There has been a great controversies on the treatment of clinical N0 neck. The purpose of this study is to analyze the outcomes of the elective neck dissection in clinical N0 neck of various sites of primary lesion. MATERIALS AND METHODS: The authors analyzed the outcomes of elective neck dissection by retrospective study with review of records of 38 head and neck cancer patients (56 sites) who had clinically N0 neck. RESULTS: The overall rate of occult neck metastasis was 31.6%. Occult neck metastasis rates according to primary sites were 37.5% (supraglottic larynx), 25.0% (glottis), 25.0% (hypopharynx) and 20. 0% (tongue) and according to T stage were 50,0% (T1), 13.3% (T2), 57.1% (T3) and 0% (T4). Four cases had nodal recurrence (1 out of 4 had occult neck metastasis) after elective neck dissections and there were no significant postoperative complications. CONCLUSION: Due to relatively high overall occult neck metastasis rate, and no significant postoperative complications, the elective neck dissection should be considered against potential possibility of occult neck metastasis in the primary sites and extent of head and neck cancers.
Subject(s)
Humans , Head , Head and Neck Neoplasms , Lymph Nodes , Neck Dissection , Neck , Neoplasm Metastasis , Postoperative Complications , Prognosis , Recurrence , Retrospective StudiesABSTRACT
BACKGROUND AND OBJECTIVES: Laryngeal cancer is the most common malignant tumor within head and neck and is known for having a good prognosis in comparison to the other malignancies. The surgery to the larynx and neck is one of the prime treatment modality for the laryngeal cancer. The purpose of this study is to review the surgical experience of our hospital and to focus on the results of the surgical treatment of the laryngeal cancer. MATERIALS AND METHODS: Analyzed 41 laryngeal cancer patients who underwent surgery during the period of 5 years from January 1989 to December 1993. TNM staging of the disease was done by the AJCC staging system issued in 1992. The 5-year survival rate was calculated by Kaplan-Meier method. RESULTS: 1) The overall 5-year survival rate was 65.8%. 2) The 5-year survival rate according to clinical stage showed 100%, 83.3%, 76.9%, and 50% in stage I, II, III, IV respectively. 3) The 5-year survival rate according to T stage showed 75%, 66.7%, 57.9%, 77.8%, in T1, T2, T3, T4 respectively. 4) The 5-year survival rate according to nodal status showed N(-) 78.9%, N(+) 56.2%. 5) The 5-year survival rate according to primary site showed supraglottis 60%, glottis 100%, transglottis 57.1%. 6) The 5-year survival rate according to treatment modalities showed surgery only patients 80%, postoperative radiation patients 60%, salvage operation patients 54.6%. CONCLUSION: Early stage, glottic cancer and the patients who only had operation showed good treatment result. Regional lymph node metastasis, at the time of diagnosis, was found to carry a worse prognosis. The main cause of treatment failure was distant metastasis.