PMID- 26884365
OWN - NLM
STAT- MEDLINE
DCOM- 20160706
LR  - 20220318
IS  - 1097-6817 (Electronic)
IS  - 0194-5998 (Print)
IS  - 0194-5998 (Linking)
VI  - 154
IP  - 3
DP  - 2016 Mar
TI  - Occult Nodal Disease Prevalence and Distribution in Recurrent Laryngeal Cancer 
      Requiring Salvage Laryngectomy.
PG  - 473-9
LID - 10.1177/0194599815627811 [doi]
AB  - OBJECTIVES: The indications for neck dissection concurrent with salvage 
      laryngectomy in the clinically N0 setting remain unclear. Our goals were to 
      determine the prevalence of occult nodal disease, analyze nodal disease 
      distribution patterns, and identify predictors of occult nodal disease in a 
      salvage laryngectomy cohort. STUDY DESIGN: Case series with planned data 
      collection. SETTING: Tertiary academic center. SUBJECTS: Patients with persistent 
      or recurrent laryngeal squamous cell carcinoma (LSCC) after 
      radiation/chemoradiation failure undergoing salvage laryngectomy with neck 
      dissection. METHODS: We analyzed a single-institution retrospective case series 
      of patients between 1997 and 2014 and identified those who had clinically N0 
      (cN0) necks (n = 203). Clinical and pathologic data, including nodal prevalence 
      and distribution, were collected and statistical analyses performed. RESULTS: 
      Overall, cN0 necks had histologically positive occult nodes in 17% (n = 35) of 
      cases. Univariate predictors of occult nodal positivity included recurrent T4 
      stage (34% T4 vs 12% non-T4; P = .0003) and supraglottic subsite (28% 
      supraglottic vs 10% nonsupraglottic; P = .0006). Histologically positive nodes 
      associated with supraglottic primaries were most frequently positive in 
      ipsilateral levels II and III (17% and 16%). Positive nodes for glottic LSCC were 
      most frequently positive in the ipsilateral and contralateral paratracheal nodes 
      (11% and 9%). CONCLUSION: Histologically positive occult nodes are identified in 
      17% of cN0 patients undergoing salvage laryngectomy with neck dissection. Occult 
      nodal disease varies in frequency and distribution based on tumor subsite. 
      Predictors of high (>20%) occult nodal positivity include T4 tumors and 
      supraglottic subsite. In glottic LSCC, the most frequent sites of occult nodal 
      disease are the paratracheal nodal basins.
CI  - (c) American Academy of Otolaryngology-Head and Neck Surgery Foundation 2016.
FAU - Birkeland, Andrew C
AU  - Birkeland AC
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health 
      System, Ann Arbor, Michigan, USA.
FAU - Rosko, Andrew J
AU  - Rosko AJ
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health 
      System, Ann Arbor, Michigan, USA.
FAU - Issa, Mohamad R
AU  - Issa MR
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health 
      System, Ann Arbor, Michigan, USA.
FAU - Shuman, Andrew G
AU  - Shuman AG
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health 
      System, Ann Arbor, Michigan, USA.
FAU - Prince, Mark E
AU  - Prince ME
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health 
      System, Ann Arbor, Michigan, USA.
FAU - Wolf, Gregory T
AU  - Wolf GT
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health 
      System, Ann Arbor, Michigan, USA.
FAU - Bradford, Carol R
AU  - Bradford CR
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health 
      System, Ann Arbor, Michigan, USA.
FAU - McHugh, Jonathan B
AU  - McHugh JB
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health 
      System, Ann Arbor, Michigan, USA.
FAU - Brenner, J Chad
AU  - Brenner JC
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health 
      System, Ann Arbor, Michigan, USA.
FAU - Spector, Matthew E
AU  - Spector ME
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health 
      System, Ann Arbor, Michigan, USA mspector@med.umich.edu.
LA  - eng
GR  - T32 DC005356/DC/NIDCD NIH HHS/United States
GR  - U01 DE025184/DE/NIDCR NIH HHS/United States
GR  - U01DE025184/DE/NIDCR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20160216
PL  - England
TA  - Otolaryngol Head Neck Surg
JT  - Otolaryngology--head and neck surgery : official journal of American Academy of 
      Otolaryngology-Head and Neck Surgery
JID - 8508176
SB  - IM
MH  - Carcinoma, Squamous Cell/epidemiology/*pathology/*surgery
MH  - Diagnostic Imaging
MH  - Female
MH  - Humans
MH  - Laryngeal Neoplasms/epidemiology/*pathology/*surgery
MH  - *Laryngectomy
MH  - Lymphatic Metastasis/*pathology
MH  - Male
MH  - Middle Aged
MH  - Neck Dissection
MH  - Neoplasm Grading
MH  - Neoplasm Recurrence, Local/epidemiology/*pathology/*surgery
MH  - Neoplasm Staging
MH  - Prevalence
MH  - Retrospective Studies
MH  - Salvage Therapy/*methods
MH  - Treatment Outcome
PMC - PMC4786166
MID - NIHMS763267
OTO - NOTNLM
OT  - laryngectomy
OT  - neck dissection
OT  - node
OT  - occult disease
OT  - prevalence
OT  - salvage
COIS- Conflicts of Interest: None
EDAT- 2016/02/18 06:00
MHDA- 2016/07/07 06:00
PMCR- 2016/03/10
CRDT- 2016/02/18 06:00
PHST- 2015/08/28 00:00 [received]
PHST- 2015/12/30 00:00 [accepted]
PHST- 2016/02/18 06:00 [entrez]
PHST- 2016/02/18 06:00 [pubmed]
PHST- 2016/07/07 06:00 [medline]
PHST- 2016/03/10 00:00 [pmc-release]
AID - 0194599815627811 [pii]
AID - 10.1177/0194599815627811 [doi]
PST - ppublish
SO  - Otolaryngol Head Neck Surg. 2016 Mar;154(3):473-9. doi: 10.1177/0194599815627811. 
      Epub 2016 Feb 16.