Management of N0 neck in T1-T2 unilateral supraglottic cancer

Early-stage supraglottic cancers (stage I and II) are treated with several different programs. Previously reported data have led us to design a therap eutic protocol in treatment of patients with early-stage squamous cell carc inoma of the supraglottic larynx. From 1991 to 1996, 39 patients with unila teral supraglottic carcinoma were treated according to this protocol. All p atients underwent unilateral functional neck dissection and resection of th e primary carcinoma in an en bloc fashion. Histopathologic studies showed t hat 9 (23%) of them had positive nodes, and they received planned adjuvant radiotherapy. None of the 30 patients with histopathologically N0 necks rec eived either adjuvant irradiation or contralateral neck dissection. The mea n follow-up period was 34 months. All patients are alive, and none have dev eloped any recurrence in either dissected or undissected sides of the neck. This treatment policy seems satisfactory and will avoid unnecessary therap eutic interventions. Routine bilateral, neck dissection may not be necessar y in the surgical treatment of all supraglottic laryngeal cancers.