Evaluation of correlation between tumor invasion depth and cervical lymph node metastasis in laryngeal squamous cell carcinoma

Abstract

Usually first metastasis involves cervical lymph nodes in laryngeal cancer. However, even today neck metastasis definiation is not sufficient. In squamous cell carcinoma of the larynx, many clinical and histopathologic parameters have been investigated as possible prognostic factors, to determine the ultimate outcome of a patient with a particular tumor and the need for an adjuvant therapy. To determine the prognostic significance of depth of tumor invasion in laryngeal cancer the depth of tumor invasion was measured with an ocular micrometer on the laryngectomy specimens of 30 surgically treated patients with laryngeal cancer and was expressed in millimeters. The rate of cervical lymph node metastasis in this study was always significantly higher in tumors with a depth of invasion equal to or greater than 7.75 mm as compared to tumors with a depth of invasion less than 7.75 mm. The mean depth of invasion in clinically N0 patients was significantly different from those clinically N+ cases. The difference was statistically significant (p=0.021). The same result was obtained between pathologically N0 pathologically N1, N2 cases (p=0.01). According to our results, depth of invasion affects cervical lymph node metastasis and deeper invading tumors have a higher risk of cervical metastasis than superficial invading ones. Depth of invasion can also be used for evaluation of lymph node metastasis and therefore for determination of necessity of elective lymph node dissection. So, we suggest that the depth of invasion should be measured in every laryngectomy specimen.

Keywords

• laryngeal cancer
• cervical lymph node metastasis
• depth of invasion.