Prognostic significance and frequency of the metastatic paratracheal lymph node in advanced larynx cancers with subglottic extension

Aim: The present study sougth to determine the frequency and prognostic value of metastatic paratracheal lymph nodes in patients with advanced stage laryngeal cancers with subglottic extension. Materials and Methods: We retrospectively evaluated the patients who underwent total laryngectomy with paratracheal lymph node dissection due to advanced stage laryngeal cancer with subglottic extension between 2010 and 2018 in our center. The frequency and prognostic value of metastatic paratracheal lymph nodes was investigated. The degree of subglottic extension was measured from the superior border of the cricoid cartilage to inferior side. Patients were divided into 2 groups as with and without metastatic paratracheal lymph nodes (Paratracheal N+ and N0). Demographic data, operation characteristics, histopathological findings, stages, follow-up data were retrospectively collected from our institutional database. Results: A sum of 39 patients were included in our study. Among these patients, 12 patients (30.8%) had paratracheal metastatic lymph nodes. There was no significant difference between the two groups in terms of the degree of subglottic extension, cartilage invasion and some pathological risk factors such as tumor differentiation, vascular invasion, perineural invasion and perinodal extension. The frequency of metastatic lateral cervical lymph node was significantly higher in patients in the Paratracheal N+ group (p=0.037). The survival of the patients with metastatic paratracheal lymph nodes was also significantly lower even after the treatment (p=0.018). Conclusion: Our study showed that there is a high rate of metastatic paratracheal lymph node in patients with advanced stage laryngeal cancer with subglottic extension, therefore we suggest that elective paratracheal dissection seems to be a beneficial at these patients