[Results of functional latero-cervical dissection associated with post-operative radiotherapy in 102 cases of carcinoma of the larynx with lymph node metastases].

Abstract

Our study analyze retrospectively 102 patients (96 male and 6 female), affected by laryngeal carcinoma with histological lymph node metastases, who came under observation from 1978 to 1984. All patients underwent partial (25 cases) or total (77 cases) laryngectomy with functional neck dissection and postoperative radiotherapy with functional neck dissection and postoperative radiotherapy. Irradiation to the neck was administered, employing Cobalt 60, through two lateral opposing fields or an anterior and two posterior fields for a total dose of 50-60 Gy (fraction of 2 Gy for 5 days/week). According to UICC classification (1982) the distribution of cases was as follow: 4 T1, 28 T2, 54 T3, 16 T4. Relatively to the localization of the tumours we had 63 supraglottic, 35 glottic and 4 subglottic involvement. The histological grading was certified in 68 cases: 12 G1, 39 G2, 17 G3; extracapsular spread was found in 20/54 cases (37%). The actuarial global and NED survivals of the whole study were respectively 68.5% and 59.8% for 3 years and 56.5% and 48.2% for 5 years. In relation to the T the global and NED survival for 5 years 67.7% and 61.8% for T1-T2 and 53.1% and 46.4% for T3. The recurrences, observed in 26 patients were found, after 3 years follow up, in 25% of G1, 20.5% of G2 and 47.1% of G3. With relation to the integrity of the nodal capsule N-recurrences were found in 20% of R+ and 5.9% of R-. At the end of the Authors underline the importance of postoperative radiotherapy in the treatment of histological N+ cancers of the larynx and the significance of histological grading and extra-capsular spread in cervical nodes as prognostic factors.