Occult Lymph Node Metastasis in Early‐Stage Glottic Cancer in the National Cancer Database

Objectives Early‐stage glottic cancer (cT1–T2 cN0) may be treated by primary surgery or radiation. Elective treatment of the neck in clinically N0 disease is usually not performed due to low rates of regional lymph node metastasis. This study examines the role of elective neck dissection (END) and r...

Full description

Saved in:
Bibliographic Details
Published in:The Laryngoscope 2021-04, Vol.131 (4), p.E1139-E1146
Main Authors: Patel, Tirth R., Eggerstedt, Michael, Toor, Jaijeet, Tajudeen, Bobby A., Husain, Inna, Stenson, Kerstin, Al‐Khudari, Samer
Format: Article
Language:English
Subjects:
Aged
Cancer
Databases, Factual
Female
Glottis - pathology
Glottis - surgery
Humans
Laryngeal Neoplasms - mortality
Laryngeal Neoplasms - pathology
Laryngeal Neoplasms - surgery
Laryngoscopy
Larynx, glottis, cancer, national cancer database, NCDB, occult lymph node, neck dissection
Lymphatic Metastasis - pathology
Lymphatic system
Male
Metastasis
Middle Aged
Neck Dissection
Neoplasm Staging
Retrospective Studies
Survival Rate
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objectives Early‐stage glottic cancer (cT1–T2 cN0) may be treated by primary surgery or radiation. Elective treatment of the neck in clinically N0 disease is usually not performed due to low rates of regional lymph node metastasis. This study examines the role of elective neck dissection (END) and rate of occult nodal metastasis in cT1–T2 cN0 glottic cancer treated with primary surgery. Study Design Retrospective cohort study. Methods The National Cancer Database was used to identify patients treated for early‐stage glottic cancer. Demographic variables, disease characteristics, and overall survival were compared between the subgroups of patients who did and did not receive END. Factors predictive of occult lymph node metastasis were also identified using a multivariate logistic regression model. Results Thirty‐eight percent of the 991 patients in this cohort underwent END. Younger age, treatment at an academic facility, advanced T‐stage, and higher tumor grade were associated with receiving END. Sixteen percent of the 372 patients undergoing END had occult nodal metastasis. Higher tumor histopathologic grade was associated with occult metastasis (P = .004). While undergoing END did not affect significantly survival, those with occult metastasis had poorer survival (P
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.28995