Yılmaz ÖZKUL, Rıza DÜNDAR, ABDÜLKADİR İMRE, Seçil ARSLANOĞLU, Elif DİNÇER, Düzgün ATEŞ, ERCAN PINAR, Kazım ÖNAL

Level IIb lymph node metastasis in transglottic laryngeal squamous cell carcinoma

Amaç: Çalışmanın amacı transglottik laringeal karsinomda level IIbmetastazı ile ilişkili klinik ve patolojik paremetreleri araştırmaktır. Yöntem:2006 Ocak ve 2014 Ocak arasında üçüncü basamak kliniğimizde parsiyel veya total larenjektomi uygulanan 238 hastanın medikal kayıtları retrospektif olarak tarandı. Bu 238 hastadan transglottiklarinks skuamöz hücreli karsinomu olan 134'ü bu çalışmaya dahil edildi. Boyun diseksiyonu tipi, histopatolojik lenf nodları ve lokalizasyonları, klinik N evresi ve T evresi verileri değerlendirildi. Palpabl lenfnodlarının varlığında klinik olarak boyun pozitif cN(+) olarak kabuledildi. Bulgular:Yüz otuz dört hastanın 116'sı cN(-) ve 18'i cN(+) olaraksaptandı. Level IIb metastazı cN(+) grupta 12 hastada, cN(-) grupta2 hastada bulundu. Histopatolojik level IIb metastazı 134 hastanın14'ünde ve 268 boyun diseksiyonu spesmeninin 16'sında saptandı.Level IIb metastazı ipsilateral spesimenlerin 12'sinde ve kontralateral spesmenlerin 2'sinde gösterildi. 134 hastanın 41'inde tiroid kartilaj invazyonu mevcuttu ve bu hastaların 9'unda aynı zamanda levelIIb metastazı vardı. Sonuç:Larinks kanserlerinde tiroid kartilaj invazyonu, level IIa metastazı ve ileri evre olması level IIb metastazı için risk faktörü olarakbulundu. Bu nedenle transglottik karsinomlarda level IIb diseksiyonuihmal edilmemelidir

Transglottik larinks skuamöz hücreli karsinomlardalevel IIb lenf nodu metastazı

Objective:To evaluate the clinical and pathologic parameters associated with level IIb metastasis in transglottic laryngeal carcinoma. Methods:A total of 238 laryngeal squamous cell carcinoma patientsadmitted to our tertiary center and surgically treated between January2006 and January 2014. Of these 238 patients, 134 patients with transglottic laryngeal SCC were enrolled in the study. The type of neck dissection, the location of histopathologically proven metastatic lymphnodes, clinical N and T stages were reviewed. Palpable lymph nodeswere accepted clinically cN(+) and the opposite as cN(-). Results: Of the 134 patients, 116 were diagnosed as cN(-), and 18were as cN(+). Level IIb metastasis was diagnosed in 12 patients in thecN(+) group, and in two patients in the cN(-) group.Histopathological level IIb metastasis was shown in 14 of 134 patients,representing 16 of 268 neck dissection specimens. Level IIb metastasis was shown in the ipsilateral specimens in 12 patients and contralateral specimens in two patients. Forty-one of 134 patients presentedcartilage invasion, and nine of them were diagnosed with level IIbmetastasis.Conclusion:Thyroid cartilage invasion, the presence of level IIa invasion and advanced stage disease are the risk factors for level IIb metastasis. Therefore, level IIb should not be neglected during neck dissection in transglotticlaryngeal carcinoma

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