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Role of Neck Dissection in Organ-Preservation for Glottic Squamous Cell Carcinoma

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

The surgical approach to the neck in laryngeal cancer depends on the tumor site and stage. Clinical practice guidelines recommend elective neck dissection in ≥ T2 N0 and all supraglottic cancers; however, there is no evidence supporting these recommendations. The objective is to evaluate the results of bilateral elective neck dissection in patients with glottic cancer who underwent supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP). Thirty-five patients diagnosed with ≥ T2 N0 laryngeal squamous cell carcinoma (LSCC) in a single-center retrospective study. Right-sided neck dissections yielded 900 lymph nodes, none of which were positive for metastatic disease. Left-sided neck dissections yielded 949 lymph nodes, one of which was positive for malignancy. Prelaryngeal (Delphian) neck dissection was performed in all patients. Out of 50 lymph nodes removed; one was positive for malignancy. Median overall survival was 172 months, and the 60-month overall survival was 87.3%. The 60-month disease-specific survival was 97.1%. Bilateral neck dissection and Delphian node dissection showed a low rate of metastasis (2.8%). Radical neck dissection may thus represent overtreatment; however, this surgical procedure could be justified to prevent regional recurrences.

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References

  1. Forastiere AA, Ismaila N, Lewin JS et al (2018) Use of larynx-preservation strategies in the treatment of laryngeal cancer: american society of clinical oncology clinical practice guideline update. J ClinOncol 10(36):1143–1169

    Article  Google Scholar 

  2. Luna-Ortiz K, Villavicencio-Valencia V, Rodríguez-Falconi A et al (2016) Induction chemotherapy followed by supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) in T3NO arytenoid fixation-related glottic cancer. B-ENT 12:271–277

    Google Scholar 

  3. Herrera-Gómez A, Villavicencio-Valencia V, Rascón-Ortiz M, Luna-Ortiz K (2009) Demographic data of laryngeal cancer at the InstitutoNacional de Cancerología in Mexico City. Cir Cir 77:353–357

    Google Scholar 

  4. National Comprehensive Cancer Network. Head and Neck Cancers (Version 3.2019). Accessed April 1st, 2020.

  5. Jones TM, De M, Foran B, Harrington K, Mortimore S (2016) Laryngeal cancer: United Kingdom national multidisciplinary guidelines. J LaryngolOtol 130:S75–S82

    Article  CAS  Google Scholar 

  6. Ahn SH, Hong HJ et al (2017) Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery. ClinExpOtorhinolaryngol 10:1–43

    Google Scholar 

  7. Cayonu M, Tuna EU, Acar A et al (2019) Lymph node yield and lymph node density for elective level II-IV neck dissections in laryngeal squamous cell carcinoma patients. Eur Arch Otorhinolaryngol 276:2923–2927

    Article  Google Scholar 

  8. Brazilian Head and Neck Cancer Study Group (1999) End results of a prospective trial on elective lateral neck dissection vs type III modified radical neck dissection in the management of supraglottic and transglottic carcinomas. Head Neck 21:694–702

    Article  Google Scholar 

  9. Chone CT, Kohler HF, Magalhães R, Navarro M, Altemani A, Crespo AN (2012) Levels II and III neck dissection for larynx cancer with N0 neck. Braz J Otorhinolaryngol 78:59–63

    Article  Google Scholar 

  10. Diaz FL, Lima RA, Manfro G et al (2009) Management of the N0 neck in moderately advance squamous carcinoma of the larynx. Otolaryngol Head Neck Surg 141:59–65

    Article  Google Scholar 

  11. Amar A, Chedid HM, Franzi SA, Rapoport A (2012) Neck dissection in squamous cell carcinoma of the larynx: indication of elective contralateral neck dissection. Braz J Otorhinolaryngol 78:7–10

    Article  Google Scholar 

  12. Laccourreye H, Ménard M, Fabre A, Brasnu D, Janot F (1987) Partial supracricoidlaryngectomy. Technics indications and results. Ann OtolaryngolChirCervicofac. 104:163–173

    CAS  Google Scholar 

  13. Myers EN, Fagan JF (1999) Management of the neck in cancer of the larynx. Ann Otol Rhinol Laryngol 108:828–832

    Article  CAS  Google Scholar 

  14. Gallo O, Boddi V, Bottai GV, Parrella F, Storchi OF (1996) Treatment of the clinically negative neck in laryngeal cancer patients. Head Neck 18:566–572

    Article  CAS  Google Scholar 

  15. Shi Y, Zhou L, Tao L et al (2019) Management of the N0 neck in patients with laryngeal squamous cell carcinoma. Acta Otolaryngol 139:908–912

    Article  CAS  Google Scholar 

  16. Riviere D, Mancini J, Santini L et al (2019) Nodal metastases distribution in laryngeal cancer requiring total laryngectomy: therapeutic implications for the N0 Neck. Eur Ann Otorhinolaryngol Head Neck Dis 136:S35–S38

    Article  CAS  Google Scholar 

  17. Weber PC, Johnson JT, Myers EN (1993) Impact of bilateral neck dissection on recovery following supraglottic laryngectomy. Arch Otolaryngol Head Neck Surg 119:61–64

    Article  CAS  Google Scholar 

  18. Xiao CC, Imam SA, Nguyen SA et al (2019) Neck dissection does not add to morbidity or mortality of laryngectomy. World J Otorhinolaryngol Head Neck Surg 5:215–221

    Article  Google Scholar 

  19. Luna-Ortiz K, Mosqueda-Taylor A (2005) Delphian lymph node in glottic carcinoma subjected to supracricoid partial laryngectomy with cricohyoidoepiglottopexy. Cir Cir 73:7–10

    Google Scholar 

  20. Som PM, Curtin HD, Mancuso AA (2000) Imaging-based nodal classification for evaluation of neck metastatic adenopathy. AJR Am J Roentgenol 174:837–844

    Article  CAS  Google Scholar 

  21. Geminiani M, Aimoni C, Scanelli G, Pastore A (2007) Parathyroid function study in patients submitted to laryngeal surgery for squamous cell carcinoma. Acta Otorhinolaryngol Ital 27:123–125

    CAS  Google Scholar 

  22. Lo Galbo AM, de Bree R, Kuik DJ, Lips P, Leemans CR (2010) Paratracheal lymph node dissection does not negatively affect thyroid dysfunction in patients undergoing laryngectomy. Eur Arch Otorhinolaryngol 267:807–810

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Head and Neck Surgery, Instituto Nacional de Cancerologia (Mexico), Av. San Fernando # 22, Col. Sección XVI, 14080, Tlalpan Mexico CDMX, Mexico

    Kuauhyama Luna-Ortiz & Luis C. Zacarías-Ramón

  2. Department of Surgery (Head and Neck Surgey), Hospital General Manuel Gea Gonzalez (Mexico), Mexico City, Mexico

    Kuauhyama Luna-Ortiz

  3. Basic and Clinical Research, Instituto Nacional de Cancerología (Mexico), Av. San Fernando #22, Col. Sección XVI, 14080, Tlalpan, Mexico City, Mexico

    Nancy Reynoso-Noverón

  4. Universitatea de Medicinâ Si Farmacie Grigorie T. Popa IASI (visitor medical student), Mexico City, Mexico

    Zelik Luna-Peteuil

  5. Surgical Oncology, Instituto Nacional de Cancerología (Mexico), Av. San Fernando #22, Col. Sección XVI, 14080, Tlalpan, Mexico City, Mexico

    Dorian Y. García-Ortega

Authors
  1. Kuauhyama Luna-Ortiz
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  2. Nancy Reynoso-Noverón
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  3. Luis C. Zacarías-Ramón
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  4. Zelik Luna-Peteuil
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  5. Dorian Y. García-Ortega
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Correspondence to Kuauhyama Luna-Ortiz.

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The authors declare that they have no competing interests.

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This study was reviewed and approved by the Institutional Review Board and registered under the number IRB 2019/0116.

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Informed consent was done for treatment according to the Mexican law.

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Luna-Ortiz, K., Reynoso-Noverón, N., Zacarías-Ramón, L.C. et al. Role of Neck Dissection in Organ-Preservation for Glottic Squamous Cell Carcinoma. Indian J Otolaryngol Head Neck Surg 74 (Suppl 3), 5865–5870 (2022). https://doi.org/10.1007/s12070-021-02470-7

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  • DOI: https://doi.org/10.1007/s12070-021-02470-7

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