Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-16T07:28:39.525Z Has data issue: false hasContentIssue false
  • English
  • Français

Interjugular neck dissection and post-operative irradiation for neck control in advanced glottic cancers – are we justified?

Published online by Cambridge University Press:  29 June 2007

Ashok M. Shenoy ,
A. Nanjundappa ,
Pradeep Kumar ,
Rekha V. Kumar ,
B. K. M. Reddy ,
V. Kannan  and
N. Anantha
Ashok M. Shenoy*
Affiliation:
Departments of Head and Neck Surgery, The Kidwai Memorial Institute of Oncology, Hosur Road, Banagalore, India.
A. Nanjundappa
Affiliation:
Departments of Head and Neck Surgery, The Kidwai Memorial Institute of Oncology, Hosur Road, Banagalore, India.
Pradeep Kumar
Affiliation:
Departments of Head and Neck Surgery, The Kidwai Memorial Institute of Oncology, Hosur Road, Banagalore, India.
Rekha V. Kumar
Affiliation:
Departments of Oncopathology, The Kidwai Memorial Institute of Oncology, Hosur Road, Banagalore, India.
B. K. M. Reddy
Affiliation:
Departments of Radiation Oncology, The Kidwai Memorial Institute of Oncology, Hosur Road, Banagalore, India
V. Kannan
Affiliation:
Departments of Radiation Oncology, The Kidwai Memorial Institute of Oncology, Hosur Road, Banagalore, India
N. Anantha
Affiliation:
Departments of Radiation Oncology, The Kidwai Memorial Institute of Oncology, Hosur Road, Banagalore, India
*
Dr Ashok M. Shenoy, Department of Head and Neck Surgery, Kidwai Memorial Institute of Oncology, Hosur Road, Bangalore, India-5600029.
Get access Rights & Permissions [Opens in a new window]

Abstract

At the Kidwai Memorial Institute of Oncology, advanced laryngeal cancers are subjected routinely to primary surgery and/or post-operative radiotherapy (RT). The surgery consists of wide field laryngectomy which entails total laryngectomy, ipsilateral/bilateral thyroid lobectomy, bilateral paratracheal clearance, and bilateral clearance of levels 2, 3 and 4 lymphatics. Post-operative RT is indicated in event of the following histopathological (HPE) situations to consolidate local-regional control: (1) T4 primary; (2) significant subglottic extension; and (3) jugular/paratracheal metastatic deposits. This prospective study highlights the therapeutic efficacy of this protocol at our centre in 45 consecutive T4/T3 glottic cancers and specifically evaluates the role of interjugular dissection and/or post-operative RT in prevention of regional recurrence. Fifty-two per cent of primary lesions needed a post-surgical upstaging as against 14 per cent of the neck lesions. Accordingly 91 per cent of the cases (41/45) qualified for post-operative RT and 82 per cent (37/41) complied with the prescribedschedule. Recurrent disease in the lateral neck was noted in 2/37 who received the prescribed schedule and 1/4 non-compliant cases; while a recurrent central neck disease was noted in 1/37 and 1/4 of these cases respectively. All cases were followed-up for a period of two years and 66 per cent of the evaluable cases for a period of five years. This study confirms conclusively that our treatment schedule yields extremely gratifying two-year local-regional control rates of 89 per cent which translates into a two and five-year actuarial survival rate of 92 and 70 per cent respectively.

Keywords

Laryngeal neoplasmsNeck dissectionRadiotherapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 1 , January 1994 , pp. 26 - 29
Copyright
Copyright © JLO (1984) Limited 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Byers, R. M., Wolf, P. E.Ballantyne, A. J. (1988) Rationale for elective neck dissection. Head and Neck Surgery 10: 160–167.CrossRefGoogle Scholar
Candela, F. C.Shah, J., David, P., Jacques, A., Shah Jatin, P. (1990) Patterns of cervical node metastasis from squamous cell carcinoma of the larynx. Archives ofOtolaryngology, Head and Neck Surgery 116: 432–434CrossRefGoogle Scholar
Deo, R. P., Shenoy, A. M., Reddy, B. K. M. et al. Multimodal therapy for advanced laryngeal cancers-a third world perspective. Journal of Surgical Oncology (in press).Google Scholar
De Santo, L. (1984) T3 glottic cancer-options and consequences of the options.Laryngoscope 94: 1311–1315CrossRefGoogle ScholarPubMed
Gavilan, C.Gavilan, J. (1989) Five-year results of functional neck dissection for cancer of larynx.Archives ofOtolaryngology, Head and Neck Surgery 115: 1193–1196CrossRefGoogle Scholar
Harris, H. H., Butler, F. (1968) Surgical limits in cancer of the subglottic larynx.Archives of Otolaryngology, Head and Neck Surgery 87: 490.CrossRefGoogle ScholarPubMed
Harrison, D. F. N. (1975) Laryngectomy for subglottic lesion. Laryngoscope 85: 1208–1227CrossRefGoogle Scholar
Jackson, C.Babcock, W. W. (1931) Laryngectomy for conservation of larynx. Annals of Otology, Rhinology, and Laryngology 11: 1207–1227Google Scholar
Wang, C. C. (1974) Treatment of glottic carcinoma by megavoltage irradiation: therapy and results. American Journal of Roentgenology 120: 157–163CrossRefGoogle ScholarPubMed
Yuen, A., Medina, J. E., Goepfert, H., Fletcher, G. (1984) Management of T3 and T4 glottic carcinomas. American Journal of Surgery 148: 467–72CrossRefGoogle ScholarPubMed