Relation between PGS Invasion and LN Metastasis in SCPL

Abstract

Objective: Transglottic cancer invading PGS is characteristically known to show a high incidence of laryngeal skeleton invasion and cervical metastasis. The objective was to determine the role of paraglottic space (PGS) invasion in lymph node metastasis in patients undergoing supracricoid partial laryngectomy (SCPL). Method: We retrospectively reviewed the clinical and pathological data of 98 patients who were diagnosed with glottis laryngeal carcinoma and underwent SCPL. We examined the relationship between PGS invasion and clinicopathological factors such as age, gender, tumor stage, vocal cord mobility, anterior commissure invasion, thyroid cartilage invasion, and subglottic extension. Results: The PGS invasion rate was 60.2% (59/98). Significant correlations were found between PGS invasion and cervical lymph node metastasis ( P = .022). Fifteen of the 59 patients (25.4 %) with the PGS invasion had cervical lymph node metastasis, whereas only 3 of the 39 patients (7.7%) without any evidence of PGS invasion had lymph node metastasis. There was also a significant correlation of PGS invasion with T stage ( P = .008), vocal cord mobility ( P = .001), and subglottic extension ( P = .014). Patients with no evidence of PGS invasion may have a survival benefit even without statistical significance ( P = .118). Conclusion: PGS invasion was found to be significantly related to the presence of cervical lymph node metastasis, which suggests that could be used to predict the presence of lymph node metastasis and to determine operative extent and prognosis in patients undergoing SCPL.