Skip to main content
NCBI home page
Indian Journal of Otolaryngology and Head & Neck Surgery logoLink to Indian Journal of Otolaryngology and Head & Neck Surgery
. 2002 Oct;54(4):255–263. doi: 10.1007/BF02993738

Nodal metastases from laryngeal carcinoma and their correlation with certain characteristics of the primary tumor

Kamaljit Kaur 1,✉, Nishi Sonkhya 1,✉, A S Bapna 1,✉
PMCID: PMC3450474  PMID: 23119906

Abstract

5O cases of carcinoma larynx were included in a prospective study to detect the incidence and pattern of nodal metastases (both clinical and occult) and to study the influence of certain characteristics of the primary tumor on the incidence of nodal metastases. In our study 66% (33 cases) of the lesions were transglottic as compared to 24% (12 cases) supraglottic and 10% (5 cases) glottic lesions. The most common age group affected in our study was 51-60 years comprising 50% of the cases. The most common symptoms were hoarseness, breathlessness and difficulty in swallowing. The incidence of clinically positive neck at the time of presentation was 42% while the incidence of occult nodal metastases was found to be 27.6%. The most common levels of lymph nodes involved in our study were levels II and III (87.5% cases). Multiple level lymph node involvement was seen in 71.4% of the eases at the time of presentation. A high incidence of cervical nodal metastases was associated with the following characteristics of the primary lesion-extralaryngeal spread, infiltrating or endophytic peripheral growth pattern, poor cellular differentiation and advanced T stage. In view of the high incidence of occult nodal metastases, use of selective lateral neck dissection is advocated in patients with a clinically negative neck at the-time of presentation (early glottic carcinomas being excluded).

Key Words: Carcinoma larynx, nodal metastases

Full Text

The Full Text of this article is available as a PDF (1.0 MB).

References

  • 1.Binnie WH, Renkin KV, Mackenzie IL. Etiology of head and neck squamous cell carcinoma. J. Oral Path. 1983;12:11–29. doi: 10.1111/j.1600-0714.1983.tb00312.x. [DOI] [PubMed] [Google Scholar]
  • 2.Bocca E, Calearo C, Vincentiis I, et al. Occult meastases in cancer of the larynx and their relationship to clinical and histological aspects of the primary tumor: a four year multicentric research. Laryngoscope. 1984;94(8):1086–1090. doi: 10.1288/00005537-198408000-00017. [DOI] [PubMed] [Google Scholar]
  • 3.Cachin Y. Supraglottic carcinomas - the early cases. Laryngoscope. 1975;85:1617–1617. doi: 10.1288/00005537-197510000-00001. [DOI] [PubMed] [Google Scholar]
  • 4.Cayman GL, Frank DK. Selective neck dissection of anatomically appropriate levels is as efficacious as modified radical neck dissection for elective treatment of the clinically negative neck in patients with squamous cell carcinoma of the upper aerodigestive tract. Arch. Otolaryngol - Head and Neck Surgery. 1998;124:248–352. doi: 10.1001/archotol.124.3.348. [DOI] [PubMed] [Google Scholar]
  • 5.Ferlito A, Rinaldo A. Selective lateral neck dissection for laryngeal cancer with limited metastatic disease: is it indicated. JLO. 1998;112:1031–1033. doi: 10.1017/s0022215100142392. [DOI] [PubMed] [Google Scholar]
  • 6.Fisch UP, Sigel ME. Cervical lymphatic system as visualized by lymphangiography. Ann. Otol Rhinol Laryngol. 1964;73:869–882. [PubMed] [Google Scholar]
  • 7.Hicks WL, Kollmorgen DR, Kuriakose MA, et al. Patterns of nodal metastasis and surgical management of the neck in supraglottic laryngeal carcinoma. Otolaryngol Head Neck Surg. 1999;121(1):57–61. doi: 10.1016/S0194-5998(99)70125-7. [DOI] [PubMed] [Google Scholar]
  • 8.Houck JR, Medina JE. Management of cervical lymph nodes in squamous carcinoma of the head and neck. Semin. Surg. Oncol. 1995;11:228–228. doi: 10.1002/ssu.2980110308. [DOI] [PubMed] [Google Scholar]
  • 9.Jones AS, Roland NJ, Field JK, et al. The level of cervical lymph node metastases: their prognostic relevance and relationship with head and neck squamous carcinoma. Clin. Otolaryngol. 1994;19(1):63–69. doi: 10.1111/j.1365-2273.1994.tb01150.x. [DOI] [PubMed] [Google Scholar]
  • 10.Kalnins IK, Leonard AG, Sako K, et al. Correlation between prognosis and degree of lymph node involvement in head and neck carcinoma. Am. J. Surg. 1977;134:450–454. doi: 10.1016/0002-9610(77)90376-2. [DOI] [PubMed] [Google Scholar]
  • 11.Kashima HK. The characteristic of laryngeal cancer correlation with cervical lymph node metastases. In: Alberti PW, Bryce DP, editors. Workshops from the centennial conference on laryngeal cancer. Norwalk, CT: Appleton-Century-Crofts; 1976. pp. 855–855. [Google Scholar]
  • 12.Kirchner JA, Owen JR. Five hundred cancers of the larynx and pyriform sinus - Results of treatment of radiation and surgery. Laryngoscope. 1977;87:1288–1288. doi: 10.1288/00005537-197708000-00009. [DOI] [PubMed] [Google Scholar]
  • 13.Kleinsasser O. Revision of classification of laryngeal cancer. Is it long overdue ? (Proposal for an improved TN classification) JLO. 1992;106:197–197. doi: 10.1017/S0022215100119073. [DOI] [PubMed] [Google Scholar]
  • 14.Kowalski LP, Franco EL,, Andrade Sobrinho J. Factors influencing regional lymph node metastases from laryngeal carcinoma. Ann. Otol Rhinol Laryngol. 1995;104(6):442–447. doi: 10.1177/000348949510400605. [DOI] [PubMed] [Google Scholar]
  • 15.Leemans CR, Tiwari R, Nauta JP, et al. Regional lymph node involvement and its significance in the development of distant metastases in head and neck carcinoma. Cancer. 1993;71:452–452. doi: 10.1002/1097-0142(19930115)71:2<452::AID-CNCR2820710228>3.0.CO;2-B. [DOI] [PubMed] [Google Scholar]
  • 16.Leroux-Robert J. A statistical study of 620 laryngeal carcinomas of the glottic region personally operated upon more than 5 years ago. Laryngoscope. 1975;85:1440–1440. doi: 10.1288/00005537-197509000-00005. [DOI] [PubMed] [Google Scholar]
  • 17.Lindberg R. Distribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer. 1972;29:1446–1449. doi: 10.1002/1097-0142(197206)29:6<1446::AID-CNCR2820290604>3.0.CO;2-C. [DOI] [PubMed] [Google Scholar]
  • 18.McGavran MH, Bauer WC, Ogura JH. The incidence of cervical lymph node metastases from epidermoid carcinoma of the larynx and their relationship to certain characteristics of the primary tumor. Cancer. 1961;14:55–56. doi: 10.1002/1097-0142(196101/02)14:1<55::AID-CNCR2820140109>3.0.CO;2-2. [DOI] [PubMed] [Google Scholar]
  • 19.Micheau C, Luboinski B, Sancho H, et al. Modes of invasion of cancer of the larynx - A statistical, histological and radioclinical analysis of 120 cases. Cancer. 1976;38:346–346. doi: 10.1002/1097-0142(197607)38:1<346::AID-CNCR2820380151>3.0.CO;2-Z. [DOI] [PubMed] [Google Scholar]
  • 20.Million RR, Cassissi NJ. A multidisciplinary approach. Second edition. Philadelphia: B. Lippincott Company; 1994. Management of head and neck cancer; pp. 439–446. [Google Scholar]
  • 21.Myers E. Editorial footnote. Arch. Otolaryngol. Head and Neck Surg. 1996;122:745–745. doi: 10.1001/archotol.1996.01890210022005. [DOI] [PubMed] [Google Scholar]
  • 22.Powell J and Robin PE (1983): Cancer of the head and neck: the present state in Head and Neck Cancer edited by P. Rhys Evans, P.E. Robin and J.W.L. Fielding Tunbridge Wells: Castle House Publication 3–16.
  • 23.Shah JP, Tollefsen HR. Epidermoid carcinoma of the supraglottic larynx-role of neck dissection in initial surgical treatment. Am. J. Surg. 1974;128:494–494. doi: 10.1016/0002-9610(74)90262-1. [DOI] [PubMed] [Google Scholar]
  • 24.Spiro RH, Alfonso AE, Farr HW, et al. Cervical node metastases from epidermoid carcinoma of upper aero digestive tract. A critical assessment of current staging. Am. J. Surg. 1974;125:562–567. doi: 10.1016/0002-9610(74)90276-1. [DOI] [PubMed] [Google Scholar]
  • 25.Spiro RH, Gallo O, Shah JP. Selective jugular node dissection in patients with squamous cell carcinoma of the larynx or pharynx. Am. Surg. 1993;166:399–402. doi: 10.1016/S0002-9610(05)80341-1. [DOI] [PubMed] [Google Scholar]
  • 26.Wang Y, Tian J, Ren Z. The relationship between histologic grading of malignancy and regional lymph node metastases in squamous cell carcinoma of larynx. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 1997;11(4):160–162. [PubMed] [Google Scholar]
  • 27.Yilmaz T, Hosal S, Gedikoglu G, et al. Prognostic significance of depth of invasion in cancer of the larynx. Laryngoscope. 1998;108(5):764–768. doi: 10.1097/00005537-199805000-00025. [DOI] [PubMed] [Google Scholar]

Articles from Indian Journal of Otolaryngology and Head & Neck Surgery are provided here courtesy of Springer

RESOURCES