Do Micrometastases Detected with Cytokeratin Immunoperoxidase Reactivity Affect the Treatment Approach to Neck in Supraglottic Cancers?

Abstract

OBJECTIVES: The aim of this study was to determine the occult lymph node metastasis rates with immunoperoxidase staining for cytokeratin in supraglottic larynx cancers and to assess our approach to the neck. STUDY DESIGN: Twenty-two patients who had squamous cell carcinoma in the supraglottic region and no histopathologic metastasis in the neck who had their cancer detected with the use of hematoxylin-eosin were included in the study. All of the specimens were reevaluated with the use of immunoperoxidase staining for cytokeratin. RESULTS: Micrometastatic disease (pN1) has been detected in 3 patients (13.61%) in whom no metastasis was detected with routine histopathologic examination. CONCLUSION AND SIGNIFICANCE: Results suggest that the occult metastasis rates are higher than those detected with routine hematoxylin-eosin staining. However, because it is accepted that neck dissection alone has adequate therapeutic efficiency in pN1 patients, the detected 13.61% rate of micrometastases has not changed our treatment plan in the neck.