Occult Neck Metastasis in Larynx and Hypopharynx Squamous Cell Carcinomas Confirmed with Simultaneous Bilateral Elective Neck Dissection

BACKGROUND AND OBJECTIVES: Neck metastasis is one of the most important prognostic factor in treating head and neck squamous cell carcinomas. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal and hypopharyngeal cancer varies widely depending upon authors. However, occult metastasis rate confirmed with simultaneous bilateral elective dissection is rare. MATERIALS AND METHODS: Fifty patients (100 necks) who underwent surgery for laryngeal and hypopharyngeal squamous cell carcinomas as an initial treatment from 1992 to 1997 were evaluated. All had bilateral elective neck dissection at the time of surgery for the primary treatment. Charts and pathologic reports were reviewed. RESULT: Occult neck metastasis rate by primary site were as follows. Supraglottis ipsilateral 40% (8/20) contralateral 15% (3/20), glottis ipsilateral 18% (4/22), contralateral 0% (0/22), hypopharynx ipsilateral 88% (7/8), contralateral 25% (2/8). CONCLUSION: Supraglottic and hypopharyngeal cancer may need elective neck treatment bilaterally. Contralateral neck occult metastasis from glottic cancer was minimal.ope