ABSTRACT
Late - stage laryngeal carcinoma [T3-T4] has a high incidence of cervical metastasis. The incidence of subclinical metastasis is not well described in none irradiation and irradiation patients initially clinically [T3,T4] with negative nodes of the neck, and the treatment of these patients is contraversal. Identify the incidence of subclinical metastatic disease in [T3,T4] with negative nodes of the neck undergoing functional neck dissections with laryngectomy. And identify the incidence of subclinical metastatic disease in those patients who faild radiotherapy. Are there any benefits of Cts in those patients? And what is the most aproprait therapy? 48 [T3,T4] with negative nodes of the neck patients underwent laryngectomy with neck dissection in Al Mowasat Hospital between 1/1/2010-1/1/2012. Pathologic study of the neck dissection specimens as undertaken. The male to female ratio was 9/1, with a mean age of 62 years [range, 47 to 92 years]. Presence of subclinical metastatic disease in the neck according to stage was as follows: T3; 4 out of 27 [14.82%], T4; 6 out of 21 [28.6%]. And according to radiation was 5 out of 27 [18%], none radiation patients 5 out of 21 [24%]. The incidence of positive node on Cts was 6 out of 10 [37%] in none radiatin patients, subclinical metastasis was 3 out of 16 [18.75%]. The incidence of positive node on Cts was 7 out of 7 in radiation patients, subclinical metastasis was 5 out of 7 [71.44%]. Subclinical cervical metastasis present in T3,T4 with negative nodes of the neck laryngeal SCC patients consequantly, [14.82%-28.6%]. Radiation has small affect on the incedanse subclinical cervical metastasis to be less. The aproprait therapy of patients who failed radiotherapy and there is node on Cts. The functional neck dissection should be done. The apropriat therapy of those patients is laryngectomy with functional neck dissection because there are subclinical cervical metastasis