Long-term analysis of bilateral versus unilateral neck dissection in the treatment of early-stage supraglottic laryngeal cancer
Selin Ünsaler1, Sema Zer Toros2, Aslı Şahin Yılmaz3, Çağatay Oysu4
1Koç Üniversitesi Tıp Fakültesi, Kbb Anabilim Dalı, İstanbul
2Sağlık Bilimleri Üniversitesi Haydarpaşa Numune Eğitim Ve Araştırma Hastanesi, Kbb Anabilim Dalı, Istanbul
3Sağlık Bilimleri Üniversitesi Ümraniye Eğitim Ve Araştırma Hastanesi, Kbb Anabilim Dalı, Istanbul
4Marmara Üniversitesi Tıp Fakültesi, Kbb Anabilim Dalı,i̇stanbul
Keywords: Laryngeal cancer, neck dissection, supraglottis.
Abstract
OBJECTIVE: This study aimed to investigate the effect of routine bilateral neck dissection on the survival outcomes of supraglottic laryngeal cancer patients with lateralized tumors and clinically negative necks.
METHODS: The data of 234 patients surgically treated for supraglottic squamous cell carcinoma between January 2000 and September 2014 were retrospectively collected. Patients treated previously for head and neck cancer, patients who could not be contacted, and those with missing data were excluded. Of the remaining 187 patients, 124 patients with early-stage primaries (T1-T2) (116 males, 8 females; mean age: 55.5±9.5 years; range, 33 to 82 years) were included. Age and sex of the patients, site of the primary tumor, TNM stage, type of the neck dissection, length of follow-up, and survival rates were evaluated. The tumors were classified into three groups according to their relationship with the median line of the larynx, and the neck dissections were recorded as unilateral or bilateral. Recurrences and survival outcomes were evaluated.
RESULTS: There was no statistically significant difference in the recurrences according to tumor site groups (p=0.39). Similarly, there was no statistically significant difference in 10-year overall survival rates in patient groups according to the tumor site (p=0.072). We found no statistically significant difference in 10-year overall survival rates between the patients who underwent unilateral and bilateral neck dissection (p=0.580).
CONCLUSION: Long-term survival analysis of 124 patients with supraglottic carcinoma did not show a survival benefit of elective contralateral neck dissection in lateralized supraglottic cancer with contralateral clinically negative neck.