Frequency and prognosis of extracapsular spread in neck metastasis in supraglottic carcinomas / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To study the frequencyof extracapsular spread (ECS) in neck metastasis and its impact on prognosis in supraglottic carcinoma. METHODS A total of 177 patients with radical or modified neck dissection between Jan. 1994 and Dec. 1997 for supraglottic carcinoma were summarized. Transparent lymph node detection and a series of sectioning method were applied on all neck dissection specimens. The SPSS software package (version 11.5) was used to make statistical analysis. Survival curves were calculated with the Kaplan-Meier model. Impact of extracapsular spread on prognosis was assessed for significance with the Log-Rank test. RESULTS Eighty one patients were pathologically positive in neck specimens and the neck metastatic rate was 45.8 %. ECS was found in 32 cases and the ECS frequency was 39.5 % (32/81). The ECS was related with pathological N stage and the number of positive nodes. Patients with ECS had a higher possibility of regional recurrence and contralateral metastasis. The 5-year survival rates of patients with neck metastasis ECS- and patients with ECS+ were 61.9 % and 22.2 % respectively. The differences had statistically significance. CONCLUSION ECS in neck metastasis affects the prognosis in patients with supraglottic carcinoma. If bilateral neck dissection was not selected simultaneously, close follow-up on contralateral neck should be selected in patients with ECS because of a higher incidence of contralateral neck metastasis.