Evaluation of cervical lymph node metastasis of 1400 patients with cancer of the larynx

Objective: The main goal of the paper was to evaluate the results of surgical treatment of patients with laryngeal carcinoma, among whom cervical lymph node metastases were observed. The results of treatment were assessed after prior analysis of the following factors localization of laryngeal carcinoma, local and regional advancement, number of lymph nodes affected by metastases, the incidence of 'occult metastases', the presence of metastases in the pre-laryngeal node, the regions of the neck which were most frequently affected by metastases and supplementary irradiation treatment. Methods: An analysis of a group of 1400 patients who underwent surgery for laryngeal carcinoma in the period 1948-1992, was carried out. In all of the cases, a partial or total laryngectomy accompanied by a unilateral or bilateral surgery of the cervical lymph node system was performed. The results of the above treatment were assessed over a 5-year survival period. Results: In patients among whom metastases to the lymph nodes were observed, it is the following factors that exert an influence on survival chances: supraglottic and glottic localization of the tumor, an increase of regional and organ advancement of the tumor, number of lymph nodes affected by metastases, the presence of metastases in the 'pre-laryngeal' node and the level of the neck affected by metastases. Conclusion: The incidence of metastases in regional lymph nodes is a prognostic factor in the treatment of patients suffering from laryngeal carcinoma. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.