Histopathologically Positive Regional Neck Node Metastasis Among Patients with Laryngeal Squamous Cell Carcinoma

Authors

  • Efren Gerald L. Soliman Department of Otorhinolaryngology, College of Medicine Philippine General Hospital, University of the Philippines Manila
  • Alfredo Quintin Y. Pontejos Department of Otorhinolaryngology, College of Medicine Philippine General Hospital, University of the Philippines Manila

DOI:

https://doi.org/10.32412/pjohns.v33i1.27

Keywords:

laryngeal cancer, lymphatic metastasis, neck dissection, squamous cell carcinoma

Abstract

Objective: To determine the patterns of regional neck node metastasis in laryngeal squamous cell carcinoma in Filipinos according to subsite and clinical stage, and to determine possible factors associated with level V involvement.

Methods:

            Design:           Retrospective Case Series

            Setting:           Tertiary National University Hospital

            Participants: A chart review was conducted for patients diagnosed with laryngeal squamous cell carcinoma who underwent laryngectomy with neck dissection from January 2011 to April 2015. Medical information obtained included demographics, clinical parameters, and histopathologic reports of nodal involvement. The rate and location of positive neck nodes was recorded according to clinical stage and primary subsite. Fisher exact test was used to determine significant risk factors for level V cervical lymph node involvement.

Results: Of 56 patients included, most were male with an average age of 61 years. Most patients had cancer originating from the glottic subsite, with the majority being staged III and IVA according to the TNM classification. Histopathologically positive neck nodes were centered at levels II to IV. No significant association was seen between level V involvement and the studied clinicopathologic factors (age, sex, tumor differentiation, subsite involvement, involvement of other neck node levels).

Conclusion: Cervical neck node levels II, III, and IV are the most commonly involved in neck dissection, with many being positive for nodal metastasis for these levels. Level V nodes may be removed when clinically positive, but elective neck dissection may exclude this level. The current practice of neck dissection appears to be appropriate in terms of selecting the most likely locations of metastatic spread. Further study is recommended, with a greater population and standardized levels of neck dissection.

Keywords:  laryngeal cancer, lymphatic metastasis, neck dissection, squamous cell carcinoma

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Published

2018-07-12

How to Cite

1.
Soliman EGL, Pontejos AQY. Histopathologically Positive Regional Neck Node Metastasis Among Patients with Laryngeal Squamous Cell Carcinoma. Philipp J Otolaryngol Head Neck Surg [Internet]. 2018 Jul. 12 [cited 2024 Nov. 18];33(1):30-3. Available from: https://pjohns.pso-hns.org/index.php/pjohns/article/view/27

Issue

Vol. 33 No. 1 (2018): Philippine Journal of Otolaryngology-Head and Neck Surgery

Section

Original Articles

License

Copyright transfer (all authors; where the work is not protected by a copyright act e.g. US federal employment at the time of manuscript preparation, and there is no copyright of which ownership can be transferred, a separate statement is hereby submitted by each concerned author). In consideration of the action taken by the Philippine Journal of Otolaryngology Head and Neck Surgery in reviewing and editing this manuscript, I hereby assign, transfer and convey all rights, title and interest in the work, including copyright ownership, to the Philippine Society of Otolaryngology Head and Neck Surgery, Inc. (PSOHNS) in the event that this work is published by the PSOHNS. In making this assignment of ownership, I understand that all accepted manuscripts become the permanent property of the PSOHNS and may not be published elsewhere without written permission from the PSOHNS unless shared under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license.