[Level choice of the neck dissection in clinical N0 patients with supraglottic cancer].

OBJECTIVE

To study the characteristics of the cervical lymph node metastasis in negative node with clinically supraglottic cancer patients and decide which level should be dissected reasonably.

METHODS

57 modified neck dissection (MND) cases in the cN0 with supraglottic cancer were performed. Each lymph node in the 57 (63 sides) MND samples was studied pathologically in order to define the level of the lymph node metastasis.

RESULTS

1,877 lymph nodes were obtained in these MND samples; an average of 29.8 lymph nodes was obtained in one side. Among them 43 lymph nodes were metastasis nodes and 41 lymph nodes were located in the II, III level, 95.4% of metastasis cases. 15 cases (17 sides) in the 57 patients were metastasis (26.3%) and 14 cases of them were in the level of II and III (93.3%). Ipsilateral cervical recurrence occurred in the 3 of 57 cases in the II, III and IV level respectively. The recurrent rate was 5.3%, and 5-year survival rate was 80.7%.

CONCLUSION

II and III levels should be dissected in the supraglottic cancer with cN0 and IV level should be included when III level was involved. I and V levels should not be included when the evidence of metastasis is not enough.