성문상부 편평세포암종 N0 경부의 예방적 외측 경부청소술에서Level Ⅳ 림프절의 절제가 반드시 필요한가?
Is the Dissection of the Level Ⅳ Lymph Node Pads Necessary in the Elective LateralNeck Dissection of N0 Supraglottic Squamous Cell Carcinoma?
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Abstract
Background and Objectives：To determine whether level IV lymph nodes can be saved in the elective lateral neck dissection (LND) as a treatment for patients with squamous cell carcinoma of the supraglottic larynx. Subjects and Methods：From January 1997 to May 2002, 42 patients with supraglottic squamous cell carcinoma and a clinically N0 neck who underwent an elective LND were studied prospectively. The incidence of pathological metastasis to the level IV lymph nodes and a regional recurrence after an elective LND were evaluated. Results：Of the 42 patients, 10 (24%) had lymph nodes positive for microscopic metastatic squamous cell carcinoma. Two (5%) of the 42 patients had involvement of the level IV lymph nodes, whose clinical T-stages were above cT3. None of the clinical T1 or T2 tumors showed level IV nodal metastasis. There were two cases (5%) of the ipsilateral neck recurrence：these patients developed recurrence in the level II and stomal area, respectively. Conclusion：The level IV lymph node metastasis was rare in this study, and nodal recurrence after LND in squamous cell carcinoma of the supraglottic larynx was infrequent. Therefore, this region may be preserved in elective LND for patients with early squamous cell carcinoma of the supraglottic larynx.
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