Clinical and Histopathological Indicators of Neck Metastasis in Laryngeal Carcinoma

Authors: ŞEFİK HALİT AKMANSU, HAKAN KORKMAZ, ENGİN DURSUN, SELİM SERMET ERBEK, HAKAN GÖÇMEN, TUĞBA ÜNAL, CAVİT ÖZERİ

Abstract: Determination of cervical metastasis preoperatively is very important in planning the treatment strategy in laryngeal carcinoma. In spite of vigorous clinical and detailed high technology radiological examinations, the occult metastasis rate is between 12-17% in No necks. In recent years most of the studies are related to the clinical and histopathological risk factors that may effect cervical metastasis. In this study we reviewed the primary tumors and neck specimens of laryngeal carcinoma patients operated in our clinic retrospectively. In 46 laryngeal carcinoma patients with laryngectomy and neck dissection, the following criteria were examined; Tumor localization, T status, histologic grading, peripheral invasion pattern, perineural and vascular invasion in a follow up period of at least 2 years. Only those cases whose paraffin blocks had not deteriorated were eligible for the study. The results were compared to neck status and although statistically insignificant, a numerically positive correlation between pathological factors and neck metastases were found. Statistical analysis was done with Chi-square and Fisher tests. Sensitivity and specificity were used as indices of accuracy. In 30,4% of the cases, there were metastatic lymph nodes in the surgical specimen. The diagnostic specificity of the clinical examination was 78% and diagnostic sensitivity was 80%. In recent years an anterolateral selective instead of a comprehensive neck dissection has also been recommended for the contralateral side of the neck by others, a method also accepted in our clinic. However, it should always be kept in mind that only low risk patients who can be closely followed up are candidates for conservative treatments.

Keywords: Laryngeal carcinoma, neck node metastasis, prognostic indicators.

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