Explore the necessity of selective neck dissection for supraglottic carcinoma in T_(3,4) with clinically negative neck

Objective:To explore the necessity of selective neck dissection in patients with supraglottic carcinoma with clinically negative neck.Methods:69 cases with supraglottic carcinoma in T 3,4 N 0M 0 between 1990.1 to 2001.1 were studied,the rate of occult metastasis was analysed, and in the light of the tumor grade,they were compared. The effect on the recurrence of the selective neck dissection was observed according to the subsequent follow-up.Results:The rate of occult metastatic was observed in 36 percent of patients who underwent selective neck dissection. There was a significant difference between tumor grade 3,4 and tumor grade 1,2 in occult metastasis. The recurrence rate of the patients in T 3,4 with selective neck dissection was lower than those without selective neck dissection. Contralateral metastasis was found in 36 percent of 22 cases with apparent or occult metastasis. There are 6 cases whose primary exceeded midline among the Contralateral metastasis.Conclusion:According to our observations, it is suggested that the supraglottic carcinoma in T 3,4 with clinically negative neck was performed selective neck dissection, It was helpful for us to decrease the recurrence rate by selective neck dissection.