The relationship between depth of invasion and cervical lymph node metastasis in patients with laryngeal squamous cell carcinoma.

Abstract

Introduction: This study aimed to investigate the relationship between DOI (Depth of Invasion) and metastasis to the neck lymph nodes in patients with laryngeal squamous cell carcinoma (LSCC).

Methods: This cross-sectional observational study was conducted on all patients diagnosed with LSCC who underwent total laryngectomy and neck dissection between 2014 and 2021. DOI was measured in millimeters by a pathologist who examined the patients' specimens. Demographic information and tumor characteristics were collected and analyzed.

Results: The study included 62 patients with LSCC, of whom 23 (37%) had cervical lymph node metastasis. There were 54 (87%) male. The mean DOI was (9.91 ± 1.60) mm in the metastatic group and (7.56 ± 1.42) mm in the non-metastatic group. The results showed that tumors with a higher DOI had a higher probability of cervical lymph node metastasis ( p < 0.001), but there was no significant correlation between DOI and the number of involved lymph nodes (p = 0.318). The analysis also revealed that poorly differentiated tumors (p. value < 0.001), male patients (p. value < 0.001), and older patients (p. value < 0.001) had a higher DOI.

Conclusion: According to our results, DOI can be an important predictive factor in predicting cervical lymph node metastasis in LSCC. Therefore, measuring DOI can assist surgeons in decision-making for neck dissection. It is recommended that DOI be determined during surgery using frozen sections or pre-operatively with deep biopsy samples. Considering that laryngeal cancer with cervical lymph node metastasis has a worse prognosis, it could be concluded that greater DOI predicts worse prognosis.