The relationship between depth of invasion and cervical lymph node metastasis in patients with laryngeal squamous cell carcinoma.

INTRODUCTION

This study aimed to investigate the relationship between DOI (Depth of Invasion) and metastasis to the neck lymph nodes in patients with laryngeal squamous cell carcinoma (LSCC).

METHODS

This cross-sectional observational study was conducted on all patients diagnosed with LSCC who underwent total laryngectomy and neck dissection between 2014 and 2021. DOI was measured in millimeters by a pathologist who examined the patients' specimens. Demographic information and tumor characteristics were collected and analyzed.

RESULTS

The study included 62 patients with LSCC, of whom 23 (37%) had cervical lymph node metastasis. There were 54 (87%) male. The mean DOI was (9.91 ± 1.60) mm in the metastatic group and (7.56 ± 1.42) mm in the non-metastatic group. The results showed that tumors with a higher DOI had a higher probability of cervical lymph node metastasis ( p < 0.001), but there was no significant correlation between DOI and the number of involved lymph nodes (p = 0.318). The analysis also revealed that poorly differentiated tumors (p. value < 0.001), male patients (p. value < 0.001), and older patients (p. value < 0.001) had a higher DOI.

CONCLUSION

According to our results, DOI can be an important predictive factor in predicting cervical lymph node metastasis in LSCC. Therefore, measuring DOI can assist surgeons in decision-making for neck dissection. It is recommended that DOI be determined during surgery using frozen sections or pre-operatively with deep biopsy samples. Considering that laryngeal cancer with cervical lymph node metastasis has a worse prognosis, it could be concluded that greater DOI predicts worse prognosis.