Effect Of Different Treatments On Prognosis Of The Cervical Lymph Node Metastasis In Clinically Negative Patients With Supraglottic Laryngeal Squamous Cell Carcinoma

OBJECTIVE:To summarize the effect of different treatments on prognosis of the cervical lymph node metastasis in clinically negative patients with supraglottic laryngeal squamous cell carcinoma,and to investigate the best treatment for these patients.METHODS:This clinical retrospective study included a total of 103 patients with the cervical lymph node metastasis in clinically negative patients with supraglottic laryngeal squamous cell carcinoma initial treated in the Cancer Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College from January 2008 to May 2014.The medical records,imaging and pathological examination results were collected from these patients.All primary tumor were resected by surgical,the follow-up time was at least 5 years or until patients died.Chi-square test,Kaplan-Meier method,log-rank test were used for statistical analysis,The prognosis of different treatments such as asintraoperative neck dissection,postoperative radiotherapy,and patients' follow-up were analyzed.The difference was statistically significant withp<0.05.RESULT:1.The cervical lymph nodes of the cervical lymph node metastasis in clinically negative patients with supraglottic laryngeal squamous cell carcinoma were treated,including Primary Tumor Resection + Neck Dissection ± Postoperative Radiotherapy(group B,21.21%)and Primary Tumor Resection+Postoperative Radiotherapy(group C,28.57%).The rate of cervical lymph nodes recurrence in the group B and group C was significantly lower than that in the group of Primary Tumor Resection Only(group A,66.67%)(p<0.05).2.The cervical lymph node metastasis rate of the cervical lymph node metastasis in clinically negative patients with supraglottic laryngeal squamous cell carcinoma was 31.82%.With the increase of Tumor staging,the metastasis rate of cervical lymph nodes of the cervical lymph node metastasis in clinically negative patients with supraglottic laryngeal squamous cell carcinoma was gradually increased.In particular,there is a significant difference in the metastasis rate of cervical lymph nodes between T1+T2 and T3+T4 patients(p<0.05).3.Statistical results showed that there was no significant difference in the 5-year survival rate between the group B(81.20%)and group C(75.30%)(P>0.05),but there were significant differences between the group B(81.20%)and group A(57.60%)(p<0.05),also between the group C(75.30%)and group A(57.60%)(P<0.05).CONCLUSION:1.The cervical lymph node metastasis in clinically negative patients with supraglottic laryngeal squamous cell carcinoma with primary tumor were resected by surgical,while take appropriate treatments of the neck,including intraoperative neck dissection or postoperative radiotherapy,are better than patients' follow-up,can be significantly reduce the recurrence rate and improve the 5-year survival rate.2.This clinical retrospective study showed that the cervical lymph node metastasis rate of the cervical lymph node metastasis in clinically negative patients with supraglottic laryngeal squamous cell carcinoma was 31.82%,which is similar to the retrospective results reported in many articles.With the increase of Tumor staging,the metastasis rate of cervical lymph nodes of the cervical lymph node metastasis in clinically negative patients with supraglottic laryngeal squamous cell carcinoma was gradually increased.