Abstract
Objective: Since regional metastasis has a tremendous impact on the prognosis of laryngeal cancer, neck management is important. We reported the study regarding the necessity of level IV dissection in cN0 laryngeal carcinoma previously. Based on the previous study, we compared selective neck dissection II-III with SND II-IV in laryngeal cancer.
Method: Thirty-six patients with cN0 laryngeal cancer were randomly assigned to receive SND II-III or SND II-IV for the elective neck dissection. The estimated blood loss and the rate of postoperative chyle leakage or phrenic nerve palsy were analyzed according to the different extent of neck dissections. Oncologic results were measured.
Results: The mean age of patients was 63.4 years. Nineteen patients (52.8%) received SND II-III (group I) and 17 patients (47.2%) received SND II-IV (group II). No cases of chyle leakage or phrenic nerve paralysis were reported in both groups. Ten out of 36 patients (27.8%) had recurred. In group I, recurrence rate was 21.1% (4/19) and it was 35.3% (6/17) in group II. The 5-year recurrence-free survivals were 64.7% and 59.2% in group I and group II, respectively. The 5-year overall survivals for group I and group II were 93.3% and 86.9%, respectively.
Conclusion: Although more cases should be accumulated for a definitive demonstration, we suggest that SND II-III is an appropriate modality in the neck management of cN0 laryngeal cancer in the aspects of perioperative morbidity and oncological safety compared with SND II-IV.
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