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Patterns of neck metastasis and occult neck disease during recurrent laryngeal cancer

Published online by Cambridge University Press:  25 July 2022

A Rovira Open the ORCID record for A Rovira [Opens in a new window] ,
A Brunet Open the ORCID record for A Brunet [Opens in a new window] ,
C Tornari ,
E Ofo ,
J-P Jeannon ,
P Williamson ,
R Oakley ,
D Kim ,
A Arora  and
G Oikonomou
...Show all authors
A Rovira*
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London
A Brunet
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London
C Tornari
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London
E Ofo
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, St George's University Hospitals NHS Foundation Trust, London, UK
J-P Jeannon
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London
P Williamson
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, St George's University Hospitals NHS Foundation Trust, London, UK
R Oakley
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London
D Kim
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, St George's University Hospitals NHS Foundation Trust, London, UK
A Arora
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London
G Oikonomou
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, St George's University Hospitals NHS Foundation Trust, London, UK
T Odutoye
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, St George's University Hospitals NHS Foundation Trust, London, UK
R Simo
Affiliation:
Division of Surgical Oncology, Head and Neck Surgery, Guy's and St Thomas’ NHS Foundation Trust, London
*
Author for correspondence: Dr A Rovira, Department of Otorhinolaryngology Head and Neck Surgery, 3rd Floor Southwark Wing, Guy's and St Thomas’ Hospital NHS Foundation Trust, St Thomas’ Street, London SE1 9RT, UK E-mail: aleix.rovira@gstt.nhs.uk
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Abstract

Objective

Numerous factors are considered to impact on the rate of complications during salvage total laryngectomy procedures. Neck dissection could be one of these factors. This study analysed the pattern of lymph node metastasis and rate of occult neck disease during salvage total laryngectomy as well as the impact of neck dissection on survival and complication rates.

Method

This was a retrospective analysis of a prospectively maintained laryngectomy database in two large tertiary teaching hospitals.

Results

The rate of occult neck disease was 11.1 per cent. Most cases with occult neck disease had rT4 disease. Patients with complications, advanced tumour stage and positive margins had a significant decrease in overall survival. Patients receiving elective neck dissection did not have any survival benefit. Positron emission tomography-computed tomography showed a very high specificity and negative predictive value.

Conclusion

According to the low risk of occult neck disease when using contemporary imaging techniques as well as the lack of impact on survival, conservative management of the neck should be considered for crT1-T3 recurrence.

Keywords

Neck DissectionNeoplasm metastasisLaryngectomyPostoperative ComplicationsPositron-Emission Tomography
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 5 , May 2023 , pp. 570 - 576
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr A Rovira takes responsibility for the integrity of the content of the paper

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