| Objective:To investigate the characteristics of the cervical lymph node metastasis in the clinical N0 patients with supraglottic carcinoma and to compare the effectiveness of selective neck dissection(SND) with modified radical neck dissection(MND),radiotherapy,"wait and see", combination of neck dissection and neck irradiation for the management of it.Methods:Five treatment groups with clinical N0 supraglottic squamous cell carcinoma were retrospectively compared:32 patients who were treated with MND between March of 1989 and March of 2006;and 26 patients who were treated with SND between January 1995 and March 2006;and 22 patients who were treated with "wait and see"between march 1989 and march 2006;18 patients who were treated with radiotherapy between march 1989 and march 2006;and 35 patients who were treated with with neck dissection and neck irradiation.To collect and research the lymph nodes from neck dissectionResults:93 were studied.The occult cervical node metastases(pN+) were found in 21.5%(20/93) and 11 locate at levelⅡ(55.5%),8 related with levelⅡandⅢ(40.0%).1 was inⅡ,ⅢandⅣ.1015 nodes were geted,31 were pN+,20(64.5%)was in levelⅡ,10 was in levelⅢ(32.3%), 30 was in levelⅡandⅢ,about 96.8%.1 node was in levelⅣ(3.1%).The 5 year survival rates for SND population was 70.3%,which was not statistically different from the MND population (72.5%) and radiotherapy(72.6%) and combined therapy(69.8%),but statistically different from the "wait and see"(35.8%).Complications and period of hospitalization were both decreased in SND group comparison of MND group(11.5%vs 43.8%,18days vs 28days).Conclusion:1.LevelⅡandⅢlymph nodes were mainly related in the clinical N0 patients with supraglottic squamous cell carcinoma.So levelⅡ～Ⅲdissection could be performed in all patients with clinical N0 with supraglottic laryngeal squamous cell carcinoma.2.Comparing to the"wait and see"SND add suevival advantage.3.Comparing to the modified radical neck dissection and radiotherapy and combined therapy:①SND was good at control of the neck occult metastases;②SND could obviously loss complications related with neck dissection;③SND could avoid adverse reaction that produced by radiotherapy;④Shorten the time in the hospital,raise the efficiency.Summary:Selective neck dissection have an important role in the treatment of the clinical NO patients with supraglottic squamous cell carcinoma.
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