Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level : A Systematic Review

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Sanabria , A , Shah , J P , Medina , J E , Olsen , K D , Robbins , K T , Silver , C E , Rodrigo , J P , Suarez , C , Coca-Pelaz , A , Shaha , A R , Mäkitie , A A , Rinaldo , A , de Bree , R , Strojan , P , Hamoir , M , Takes , R P , Sjogren , E V , Cannon , T , Kowalski , L P & Ferlito , A 2020 , ' Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level : A Systematic Review ' , Cancers , vol. 12 , no. 4 , 1059 . https://doi.org/10.3390/cancers12041059

Title: Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level : A Systematic Review
Author: Sanabria, Alvaro; Shah, Jatin P.; Medina, Jesus E.; Olsen, Kerry D.; Robbins, K. Thomas; Silver, Carl E.; Rodrigo, Juan P.; Suarez, Carlos; Coca-Pelaz, Andres; Shaha, Ashok R.; Mäkitie, Antti A.; Rinaldo, Alessandra; de Bree, Remco; Strojan, Primoz; Hamoir, Marc; Takes, Robert P.; Sjogren, Elisabeth V.; Cannon, Trinitia; Kowalski, Luiz P.; Ferlito, Alfio
Contributor organization: HUS Head and Neck Center
Department of Ophthalmology and Otorhinolaryngology
University of Helsinki
Helsinki University Hospital Area
Date: 2020-04
Language: eng
Number of pages: 16
Belongs to series: Cancers
ISSN: 2072-6694
DOI: https://doi.org/10.3390/cancers12041059
URI: http://hdl.handle.net/10138/316234
Abstract: Background: Larynx cancer is a common site for tumors of the upper aerodigestive tract. In cases with a clinically negative neck, the indications for an elective neck treatment are still debated. The objective is to define the prevalence of occult metastasis based on the subsite of the primary tumor, T classification and neck node levels involved. Methods: All studies included provided the rate of occult metastases in cN0 larynx squamous cell carcinoma patients. The main outcome was the incidence of occult metastasis. The pooled incidence was calculated with random effects analysis. Results: 36 studies with 3803 patients fulfilled the criteria. The incidence of lymph node metastases for supraglottic and glottic tumors was 19.9% (95% CI 16.4-23.4) and 8.0% (95% CI 2.7-13.3), respectively. The incidence of occult metastasis for level I, level IV and level V was 2.4% (95% CI 0-6.1%), 2.0% (95% CI 0.9-3.1) and 0.4% (95% CI 0-1.0%), respectively. For all tumors, the incidence for sublevel IIB was 0.5% (95% CI 0-1.3). Conclusions: The incidence of occult lymph node metastasis is higher in supraglottic and T3-4 tumors. Level I and V and sublevel IIB should not be routinely included in the elective neck treatment of cN0 laryngeal cancer and, in addition, level IV should not be routinely included in cases of supraglottic tumors.
Subject: larynx neoplasm
neck dissection
systematic review
glottis
supraglottis
CLINICALLY NEGATIVE NECK
ELECTIVE LATERAL NECK
SELECTIVE NECK
SUBLEVEL IIB
N0 NECK
SUPPORT PRESERVATION
SURGICAL-MANAGEMENT
N-0 NECK
DISSECTION
CANCER
3122 Cancers
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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