성문상부암에서 N0 경부에 대한 예방적 방사선치료의 효과

Effectiveness of Elective Irradiation Therapy on N0 Neck in Supraglottic Cancer

Background and Objectives: Supraglottic cancer have a great tendency to spread cervical lymph nodes and lymph node metastasis is a well known prognostic factor. However the treatment for N0 neck in supraglottic cancer is still controversial. Materials and Methods: We retrospectively analyzed our neck management of supraglottic cancer patients who present with cN0 contralateral neck from 1989 through 1997. 36 patients were eligible for analysis. The primary site was surgically removed and the neck was managed by elective neck irradiation (ENI), elective neck dissection (END), or therapeutic neck dissection (TND) with postoperative radiation therapy (PORT). Results: Our results revealed that 18 of 36 patients have clinically negative neck, another 18 patients have clinically positive neck (N1-3). In clinically negative group, 12 of 18 patients were received ENI and there was 1 failure in contralateral neck area. Remaining 6 patients were received END with PORT and there was no failure. In clinically positive neck group, 3 of 18 patients were received ipsilateral TND and an additional contralateral END with PORT. Remaining 15 patients who were received TND with PORT, developed 3 neck failure. Conclusion: ENI or ipsilateral or bilateral END can be done in the cN0 neck of supraglottic cancer however ipsilateral TND and contralateral END with PORT is reasonable for the cN(+) neck.