Analysis of the relationship between cervical metastasis rate and tumor factors in laryngeal cancer and surgical treatment results of these cases

Medical records of 333 laryngeal cancer patients treated with surgery (total or partial laryngectomy) as primary treatment, combined with neck dissection and/or postoperative radiotheraphy when required, in the last ten years (between 2000-2010) at Gaziantep University Medical Faculty, Department of Otolaryngology Head and Neck Surgey were analyzed.Of these 333 patients, 178 treated with total laryngectomy, 76 with supraglottic laryngectomy, 19 with supracricoid laryngectomy, 6 with frontolateral laryngectomy, 20 with vertical laryngectomy, 17 with laryngofissure cordectomy, and 17 with endolaryngeal cordectomy.According to tumor localization; 172 (51.6%) of the cases were glottic, 108 (32.4%) of the cases were supraglottic, 53 (15.9%) of the the cases were transglottic. In glottic cancers, 18.6% cervical metastasis rate and 11.6% occult metastasis rate were dedected while in supraglottic cancers, 45.3% cervical metastasis rate, 23% occult metastasis rate were dedected. In transglottic cancer, 49% cervical metastasis rate and 22.6% occult metastasis rate were dedected.Based on histopathologic differantiation, 46.5% of the cases were detected as G1 (well differentiated), 40.8% as G2 (mildly differentiated), 12.6% as G3 (poorly differentiated). Cervical metastasis were found as 18% in well differentiated (G1) tumors, 38.2% in mildly differentiated (G2) tumors, 64.2% in poorly differentiated (G3) tumors.It was observed that by the increase of tumors T stage, cervical lymph node metastasis rate increased. Cervical metastasis rate was observed as 6% of T1 staged cases, 32% of T2 staged cases, 34% of T3 staged cases, 51.2% of T4 staged cases.82 patients died among 333 larynx carcer patients operated in our clinic between 2000-2010. Survival rate was measured 75.4% and it was observed that surveillance decreased distinctly by icreased tumor stage.Keywords: Larynx cancer, Localization, stage, Cervical lymph node metastasis, surveillance