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22 February 2002

Modified neck dissections--efficiency of surgical treatment and clinical observations.

Stanisław Chodynicki, Bogdan Łazarczyk, Teresa Woińska-Rojecka, Barbara Południewska, Jarosław Łuczaj, Jerzy Tynkiewicz, Ewa Olszewska

Med Sci Monit 2002; 8(2): CR93-95 :: ID: 420934

Abstract

BACKGROUND: The evaluation of affected lymph node number, the site of metastaticlymph nodes, and spread of neoplastic infiltration beyond the lymph capsule is considered useful in prognosis.The aim of the study was to estimate the frequency of neck nodal metastases occurrence depending on thesite of origin, the grade of larynx cancer progression, and clinical condition of neck lymph nodes. MATERIAL/METHODS:The study comprised 315 patients with larynx cancer who underwent surgery in 1994-1999. Laryngectomywas the most frequent procedure, performed in 254 patients, while partial laryngectomy was performedin 61 patients. There were 630 bilateral neck dissections; type I of modified radical surgery in 27 cases,type II in 45 cases, and type III in 558 cases. RESULTS: Neck nodal metastases were detected most rarelyin cases of glottic cancer (16%), and most frequently in transglottic cancer (56%). Most frequently,the nodal metastases affected the II level of the lymph node groups regardless of the site. Recurrencesto the neck lymph nodes were observed in 3.3% of the cases where the removed lymph nodes did not revealany metastatic changes in histopathological examinations. CONCLUSIONS: Postoperative results of the necklymph node histopathological examination point to the necessity of lymphadenectomy in the II-V levels.Selective lymphadenectomy is not advisable due to the possibility of metastases to all levels of theneck lymph nodes regardless of the primary tumor site.

Keywords: Laryngeal Neoplasms, Neck, Surgical Procedures, Operative

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750