Selective neck lymph nodes dissection for cN0 supraglottic laryngeal cancer

Objective: To compare the selective neck lymph nodes dissection and no lymph nodes cleaning for cN0 supraglottic laryngeal cancer. Methods: 103 patients with cN0 supraglottic laryngeal were randomly divided into selective neck lymph nodes dissection group (n=52), and no lymph nodes dissection group (n=51). After 3 years followed up, we used Kaplan-Meier curve and Log-rank test for survival analyzed. Results: A total of 1 126 lymph node dissected form 52 patients in selective lymph nodes neck dissection group. The average number was 21.7. Total of 14 patients detected cervical lymph node metastasis 26.9%(14/52). With the improvement of clinical stage, cN0 actual cervical lymph node metastasis rate gradually increased (χ2=11.451, P=0.010). 91 cases (59.9%), 42 cases (27.6%), 19 cases (12.5%) of 152 lymph node metastasis distributed in the neck area of district Ⅱ, Ⅲ, Ⅳ, respectively. 9 patients lost in 3 years follow-up (91.3%). 10 patients recurrence in 3-year follow-up period, 4.2% recurrence rate in selective dissection group vs 17.4% in no dissection group (χ2=4.321, P=0.038). The 1, 2 and 3 year survival rates were 95.1%, 91.4%, 89.2% and 93.9%, 86.2%, 77.5% in selective dissection group and no dissection group, respectively (χ2=3.316, P=0.014). Conclusion: ①cN0 supraglottic laryngeal cancer have a certain incidence of occult lymph node metastasis, and the Ⅱand Ⅲ are most common lymph node metastasis areas. ②The selective neck lymph node dissection reserved the anatomy of the neck, and significantly improve the treatment of postoperative survival than no lymph node dissection.