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July 1996

Critical Appraisal of Watchful Waiting Policy in the Management of NO Neck of Advanced Laryngeal Carcinoma

Author Affiliations

From the Division of Otorhinolaryngology, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong.

Arch Otolaryngol Head Neck Surg. 1996;122(7):742-745. doi:10.1001/archotol.1996.01890190038010

Objective:  To analyze the problem of nodal recurrence of NO neck advanced laryngeal carcinoma.

Design:  Retrospective analysis.

Setting:  Hospital referral center.

Patients:  One hundred thirty-three patients with cancer stages T3-T4, NO, MO who had total laryngectomy between January 1981 and December 1990.

Main Outcome Measure:  Nodal recurrence.

Results:  Of the 11 patients who had elective radical neck dissections, there was no nodal recurrence. Of the other 122 patients who had no elective neck dissection, 19 patients (16%) developed nodal recurrence and all nodal recurrence was at levels II, III, and IV. Twelve patients (63%) underwent salvage radical neck dissection for nodal recurrence and they had a 38% adjusted 5-year actuarial survival rate. Of these 122 patients who had no elective neck dissection for the NO neck, 12 patients (10%) eventually died of nodal recurrence.

Conclusion:  The watchful waiting policy is a satisfactory management option of NO neck of advanced laryngeal carcinoma.Arch Otolaryngol Head Neck Surg. 1996;122:742-745

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