The Effect Of Different Treatment Of Neck Lymph Node To Clinically Negative Neck (cN0) Of Supraglottic Laryngeal Carcinoma

PurposeTo summarize the prognostic and the therapeutic effect of different treatment of neck lymph node to clinically negative neck （cNo） of supraglottic laryngeal carcinoma （SGLC）, and to explore the significance of the SGLC patients with cNo neck received selective neck dissection of levels Ⅱ、Ⅲ and（or） IV.MethodsA retrospective analysis was undertaken for83supraglottic laryngeal squamous cell carcinoma patients with cNo from January2003to May2007at the Department of Otolaryngology, The First Affiliated Hospital of Zhengzhou University. All medical records was complete and all primary tumor were resected by surgical, the follow-up time was at least5years or until patients died. The patients’five year survival rate was analyzed between the selective neck dissection group and other three groups （neck radiotherapy group, combined therapy group and‘wait and see’ policy group）.Results1.1. The rate of cervical lymph node metastasis of supraglottic carcinoma patients with cNo neck was30.77%, and with the increasing of T stage, the rate of cervical lymph node metastasis increases gradually. The rate of cervical lymph node metastasis in early stage （T₁、 T₂） was inferior to advanced stage（T₃、T₄）（P<0.05）2. The recurrence rate of cervical lymph node with inter-operative or postoperative surgical intervention （selective neck dissection、 neck radiotherapy and combined therapy） for patients was20.96%,25.00%and20.00%respectively; The recurrence rate of cervical lymph node with no inter-operative or postoperative surgical intervention （’wait and see’） for patients was46.43%, the recurrence rate of cervical lymph node with surgical intervention inferior to a‘wait and see’ policy （P<0.05）.3. The effect of5-year survival rate of selective neck dissection group、 neck radiotherapy group、 combined therapy group was79.30%,75.00%and80.00%respectively, there is no significant difference among them （P>0.05）,and the effect of5-year survival rate of observation group was57.10%, the difference was significant between selective neck dissection group and observation group （P<0.05）Conclusions1. Supraglottic laryngeal carcinoma patients with cN₀neck have about one third cervical lymph node metastases, and the lymph node metastasis rate increase as T stage increasing.2. To the supraglottic laryngeal carcinoma patients with cNo, selective neck dissection can obviously reduce the rate of neck recurrence and increase the5-year survivals.3. Comparing to the radiotherapy and combined therapy, selective neck dissection has the similar therapy effect for the patients when the primary focuses were resected, but superior to the "wait and see".