The incidence of cervical lymph node metastases from epidermoid carcinoma of the larynx and their relationship to certain characteristics of the primary tumor.A study based on the clinical and pathological findings for 96 patients treated by primary en bloc laryngectomy and radical neck dissection

Abstract

HE CHOICE of therapy for a malignantT neoplasm is frequently governed by the probability and location ol lymph nodal metastases.I n general, tumors with a high incidence of metastases are treated by more radical procedures than are those with a low incidence.For this reason, studies dealing with the probability of metactases are important in making therapeutic decisions.Several methods for studying metastatic spread of laryngeal carcinoma to cervical lymph nodes have been used?, 73 9 9 1 2 , l j 16 but seldom has the informa tion been derived from a homogeneous sample.Thus, patients treated initially by irradiation or laryngofissure and subsequently treated by laryngectomy with or without concomitant neck dissection are included with those treated by primary en bloc laryngectomy and neck dissection.Also, proof of metastases has varied from patient follow-up studies, to clinical palpation, to histological examination.T h e findings of such studies are not stlictly applicable to the evaluation of laryngeal cancer patients being seen for the first time.iZnother factor creating difficulty is the mul-1 iplirity of classification systems for carcinoma of the larynx,2+ 8 , 1 0 , 1 3 , 1 4 1 1 6 20 each having its advantages and handicaps.T o illustrate, if 100 laryngeal cancers are split into 5 or 10 groups according to site and then subdivided as to rlinical stage of disease, the information derived is specific but based on a very limited experience.At the other extreme, such state-