Surgical Procedure and Indications for the Cervical Lymph Node Metastasis of Oropharyngeal Cancer and Laryngeal Cancer

Abstract

We observed the results of neck dissection on oropharyngeal and laryngeal cancer for the last 15 years, and report on the modified technique for neck dissection procedure, boundaries of the lymph node groups removed, and elective dissection. First, based on cases of neck dissection on oropharyngeal cancer, we showed how we decide whether a redical or a modified neck dissection procedure would be taken. Next, we calculated the frequency of positive pathological metastasis cases by lymph node group, and a certain pattern could be observed. We found that if the oropharygeal cancer was located on the lateral wall, the internal jugular group and posterior triangular group of the affected side, and the contralateral upper jugular group should be dissected. In the same way, if the oropharyngeal cancer was located on the anterior wall, the bilateral internal jugular group should be dissected. In the case of a supraglottic laryngeal cancer, the bilateral internal jugular group, and the case of glottic laryngeal cancer, the internal jugular group of the affected side as well as the paratracheal area should be dissected respectively. For the indication of elective dissection, we observed the pathological metastasis frequency of laryngeal cancer . Here, we reached the conclusion that the indication was necessary in cases of advanced supraglottic laryngeal cancer, and for residual and recurrent cases over T2 or above which underwent radiotherapy.