Upper neck (level II) dissection for NO neck supraglottic carcinoma

Objectives: Elective neck dissection for the NO neck in head and neck surge ry is still controversial. This prospective nonrandomized study of NO supra glottic carcinoma was designed to find an appropriate method of neck manage ment. Study Design: Anatomical studies show that the first echelon of lymph atic drainage from the supraglottic larynx is toward the upper jugular node s (level II). An upper neck dissection (UND) was applied and all the lymph nodes were sent for frozen section. If the subclinical metastasis was found , a modified neck dissection was performed. If the nodes harbored no foci o f cancer, the patients were observed after surgery on the supraglottic lesi ons, Methods: Patient records of 142 patients with supraglottic laryngeal c ancer (T1-4N0M0) were reviewed, with special attention paid to neck recurre nces and survival rates. The cases were treated between 1976 and 1990 and a ll were observed for at least 5 years after the operation or until the time of death, Results: The UND specimens of 142 patients were negative for met astasis. The B-year survival rate for this group after surgery was 80.8%, a ccording to the life table analysis. Fifteen of the 142 patients (10.6%) ha d neck recurrences during the period of observation within 5 years. The rec urrence rate of this series with limited dissection on the neck was compara ble with those reported in the literature after neck dissection, either rad ical or modified, Conclusions: There is no need for a comprehensive neck di ssection for NO supraglottic laryngeal cancer, A selective neck dissection such as UND (level II) or a supraomohyoid neck dissection (sparing the subm andibular region) of level II and III will serve the purpose of radical nec k treatment for the supraglottic cancer.