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Elective neck dissection for T3–T4N0 laryngeal carcinoma: evidence from Japan’s National Head and Neck Cancer Registry

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Abstract

Background

Although total laryngectomy is the standard treatment for advanced laryngeal cancer, the significance of elective neck dissection (END) for N0 laryngeal cancer remains unclear in Japan, which is an aging society.

Methods

We conducted a retrospective nationwide observational study on patients with T3–T4N0 laryngeal squamous cell carcinoma treated with curative total laryngectomy from 2011 to 2018 in Japan.

Results

A total of 1,218 patients were analyzed. The median patient age was 72 years, with 735 cases of T3N0 and 483 cases of T4N0. END was performed on the affected side in 850 patients (70%) and on the contralateral side in 502 patients (41.2%). END on the affected side was omitted in patients aged > 80 years (40.4%) and in patients with an advanced performance status. The occult lymph-node metastasis rate did not differ by age (18.8%–19.6%); it tended to increase chronologically from 2011 (11.1%) and was higher in cT4a (22.5%) and pT4a (24.3%) cases. In this study, coherent clinical information and follow-up data were available for 252 patients. Both univariate and multivariate analyses showed no significant prognostic factors for overall survival or recurrence-free survival for either affected or contralateral END. Older age and subglottic location were poor prognostic factors, but death due to factors other than laryngeal cancer could not be ignored in older patients.

Conclusion

Omission of END during laryngectomy for T3–T4N0 laryngeal cancer is acceptable for older patients who want their operation to be completed in a short time.

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Data availability

The data generated in this study are available in the article.

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Acknowledgements

We thank the Committee of the Japan Society for Head and Neck Cancer for permission to conduct this study. We also express our deepest gratitude to the head and neck surgeons throughout Japan who registered with the National Head and Neck Cancer Registry. This work was supported by JSPS KAKENHI under Grant No. 21K09556.

Author information

Authors and Affiliations

  1. Departments of Otolaryngology, Head and Neck Surgery, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Yuki Saito, Takaaki Hayashi, Koji Yamamura, Kenya Kobayashi, Osamu Fukuoka & Tatsuya Yamasoba

  2. Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan

    Seiichi Yoshimoto

  3. Clinical Study Support Center, Data Center Department, Wakayama Medical University Hospital, Wakayama, Japan

    Megumi Kitayama

  4. Department of Otolaryngology, Kobe University School of Medicine, Hyogo, Japan

    Ken-ichi Nibu

Authors
  1. Yuki Saito
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  2. Seiichi Yoshimoto
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  3. Megumi Kitayama
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  4. Takaaki Hayashi
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  5. Koji Yamamura
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  6. Kenya Kobayashi
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  7. Osamu Fukuoka
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  8. Ken-ichi Nibu
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  9. Tatsuya Yamasoba
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Contributions

YS: conception and design; development of the methodology; acquisition and analysis of the data; and writing, review, and revision of the article. SY: development of the methodology; analysis of the data; and review and revision of the article. MK: analysis and interpretation of the data; review of the article. SY: development of the methodology; analysis of the data; and review and revision of the article. TH: review and revision of the article. KY: review and revision of the article. KK: review and revision of the article. OF: review and revision of the article; development of the methodology; analysis of the data; and review and revision of the article. KN: review and revision of the article; funding acquisition. TY: review and revision of the article.

Corresponding author

Correspondence to Yuki Saito.

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Saito, Y., Yoshimoto, S., Kitayama, M. et al. Elective neck dissection for T3–T4N0 laryngeal carcinoma: evidence from Japan’s National Head and Neck Cancer Registry. Int J Clin Oncol 28, 209–220 (2023). https://doi.org/10.1007/s10147-022-02275-w

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  • DOI: https://doi.org/10.1007/s10147-022-02275-w

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