Total Laryngectomy Followed by Radiotherapy Instead of "Prophylactic" Neck Dissection: Late Results

The indication for a so-called prophylactic neck dissection performed along with laryngectomy in cases of cancer of the larynx with no palpable metastatic lymph nodes is still open to debate, especially when the cancer is not limited to the glottis. In the literature of the most recent years the opinion of the majority is definitely favoring such a procedure, though some, among which are one of us1and Leroux-Robert,2strongly support the view that in these cases laryngectomy should preferably be combined with bilateral irradiation of the neck lymph nodes. As a contribution to the above problem, an investigation was made on the results obtained in the Otorhinolaryngology Department of the University of Florence on 221 cases of cancer of the larynx.* All the reported cases showed no demonstrable metastasis at the time of operation and were primarily treated with total laryngectomy without neck dissection. In the