Nodal disease in purely glottic carcinoma: Is elective neck treatment worthwhile?

Caroline Y. Yang, Peter Andersen, Edwin C. Everts, James Cohen

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Objective: Although there is a generalized understanding of the relatively low overall incidence of nodal disease from purely glottic carcinoma, the exact role for elective neck treatment in the management of this disease remains controversial. The purpose of this study was to identify the incidence of occult nodal disease (including paratracheal) in patients who have glottic carcinoma without significant extraglottic extension and to identify which patients are at risk for this. A retrospective chart review of 92 such patients who had either undergone neck dissection or been observed for a minimum of 2 years was performed. Results: For the 92 patients, neck treatment consisted of observation in 68 patients, paratracheal node dissection in four, unilateral neck dissection in four, unilateral neck dissection and excision of paratracheal nodes in 14, and bilateral neck dissection with paratracheal node excision in two. Of the 24 nodal dissections performed, four were positive for occult metastatic disease. No patient in the observation group developed nodal disease. Conclusion: The incidence of occult nodal disease in N0 glottic carcinoma is low, 0% in early stage disease (T1-T2) and 19% in late stage disease (T3-T4). Nodes at highest risk included only the paratracheal, level II, and level III. Elective neck treatment should only be undertaken for advanced (T3-T4) disease and even then is of questionable benefit. If undertaken, it should have a low potential morbidity, such as selective neck dissection or radiation. Computed tomography was not useful in staging the neck for this subset of patients.

Original languageEnglish (US)
Pages (from-to)1006-1008
Number of pages3
JournalLaryngoscope
Volume108
Issue number7
DOIs
StatePublished - Jul 1998

Fingerprint

Tongue
Neck
Neck Dissection
Carcinoma
Therapeutics
Dissection
Incidence
Observation
Disease Management
Tomography
Radiation
Morbidity

Keywords

  • Elective neck dissection
  • Glottic carcinoma

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Nodal disease in purely glottic carcinoma : Is elective neck treatment worthwhile? / Yang, Caroline Y.; Andersen, Peter; Everts, Edwin C.; Cohen, James.

In: Laryngoscope, Vol. 108, No. 7, 07.1998, p. 1006-1008.

Research output: Contribution to journalArticle

Yang, Caroline Y. ; Andersen, Peter ; Everts, Edwin C. ; Cohen, James. / Nodal disease in purely glottic carcinoma : Is elective neck treatment worthwhile?. In: Laryngoscope. 1998 ; Vol. 108, No. 7. pp. 1006-1008.
@article{bfdf5b5a5c774b86893c53f9979cb22d,
title = "Nodal disease in purely glottic carcinoma: Is elective neck treatment worthwhile?",
abstract = "Objective: Although there is a generalized understanding of the relatively low overall incidence of nodal disease from purely glottic carcinoma, the exact role for elective neck treatment in the management of this disease remains controversial. The purpose of this study was to identify the incidence of occult nodal disease (including paratracheal) in patients who have glottic carcinoma without significant extraglottic extension and to identify which patients are at risk for this. A retrospective chart review of 92 such patients who had either undergone neck dissection or been observed for a minimum of 2 years was performed. Results: For the 92 patients, neck treatment consisted of observation in 68 patients, paratracheal node dissection in four, unilateral neck dissection in four, unilateral neck dissection and excision of paratracheal nodes in 14, and bilateral neck dissection with paratracheal node excision in two. Of the 24 nodal dissections performed, four were positive for occult metastatic disease. No patient in the observation group developed nodal disease. Conclusion: The incidence of occult nodal disease in N0 glottic carcinoma is low, 0{\%} in early stage disease (T1-T2) and 19{\%} in late stage disease (T3-T4). Nodes at highest risk included only the paratracheal, level II, and level III. Elective neck treatment should only be undertaken for advanced (T3-T4) disease and even then is of questionable benefit. If undertaken, it should have a low potential morbidity, such as selective neck dissection or radiation. Computed tomography was not useful in staging the neck for this subset of patients.",
keywords = "Elective neck dissection, Glottic carcinoma",
author = "Yang, {Caroline Y.} and Peter Andersen and Everts, {Edwin C.} and James Cohen",
year = "1998",
month = "7",
doi = "10.1097/00005537-199807000-00010",
language = "English (US)",
volume = "108",
pages = "1006--1008",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "John Wiley and Sons Inc.",
number = "7",

}

TY - JOUR

T1 - Nodal disease in purely glottic carcinoma

T2 - Is elective neck treatment worthwhile?

AU - Yang, Caroline Y.

AU - Andersen, Peter

AU - Everts, Edwin C.

AU - Cohen, James

PY - 1998/7

Y1 - 1998/7

N2 - Objective: Although there is a generalized understanding of the relatively low overall incidence of nodal disease from purely glottic carcinoma, the exact role for elective neck treatment in the management of this disease remains controversial. The purpose of this study was to identify the incidence of occult nodal disease (including paratracheal) in patients who have glottic carcinoma without significant extraglottic extension and to identify which patients are at risk for this. A retrospective chart review of 92 such patients who had either undergone neck dissection or been observed for a minimum of 2 years was performed. Results: For the 92 patients, neck treatment consisted of observation in 68 patients, paratracheal node dissection in four, unilateral neck dissection in four, unilateral neck dissection and excision of paratracheal nodes in 14, and bilateral neck dissection with paratracheal node excision in two. Of the 24 nodal dissections performed, four were positive for occult metastatic disease. No patient in the observation group developed nodal disease. Conclusion: The incidence of occult nodal disease in N0 glottic carcinoma is low, 0% in early stage disease (T1-T2) and 19% in late stage disease (T3-T4). Nodes at highest risk included only the paratracheal, level II, and level III. Elective neck treatment should only be undertaken for advanced (T3-T4) disease and even then is of questionable benefit. If undertaken, it should have a low potential morbidity, such as selective neck dissection or radiation. Computed tomography was not useful in staging the neck for this subset of patients.

AB - Objective: Although there is a generalized understanding of the relatively low overall incidence of nodal disease from purely glottic carcinoma, the exact role for elective neck treatment in the management of this disease remains controversial. The purpose of this study was to identify the incidence of occult nodal disease (including paratracheal) in patients who have glottic carcinoma without significant extraglottic extension and to identify which patients are at risk for this. A retrospective chart review of 92 such patients who had either undergone neck dissection or been observed for a minimum of 2 years was performed. Results: For the 92 patients, neck treatment consisted of observation in 68 patients, paratracheal node dissection in four, unilateral neck dissection in four, unilateral neck dissection and excision of paratracheal nodes in 14, and bilateral neck dissection with paratracheal node excision in two. Of the 24 nodal dissections performed, four were positive for occult metastatic disease. No patient in the observation group developed nodal disease. Conclusion: The incidence of occult nodal disease in N0 glottic carcinoma is low, 0% in early stage disease (T1-T2) and 19% in late stage disease (T3-T4). Nodes at highest risk included only the paratracheal, level II, and level III. Elective neck treatment should only be undertaken for advanced (T3-T4) disease and even then is of questionable benefit. If undertaken, it should have a low potential morbidity, such as selective neck dissection or radiation. Computed tomography was not useful in staging the neck for this subset of patients.

KW - Elective neck dissection

KW - Glottic carcinoma

UR - http://www.scopus.com/inward/record.url?scp=0031776128&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031776128&partnerID=8YFLogxK

U2 - 10.1097/00005537-199807000-00010

DO - 10.1097/00005537-199807000-00010

M3 - Article

C2 - 9665247

AN - SCOPUS:0031776128

VL - 108

SP - 1006

EP - 1008

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

IS - 7

ER -