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[The clinical and pathological research of supraglottic carcinoma with bilateral cervical nodal metastasis].

OBJECTIVE
To evaluate clinical and pathological characteristics in patients with supraglottic carcinoma and bilateral cervical nodal metastasis.


METHOD
60 patients with supraglottic carcinoma treated in this hospital from 1985 to 1994 were retrospectively reviewed, including 30 cases with bilateral metastasis (experiment group) and 30 cases with unilateral metastasis (control group). The two groups were contrasted according to site of tumor, tumor diameter, surface morphology, clinical staging, the degree of invading the contralateral semilarynx, Border's grading, growth mode of tumor edge, the degree of invading preepiglottic space.


RESULT
In stage T4 cases with low grading of cell differentiation made up 63.6% (7/11) in the bilateral metastasis group, while 10% in the ipsilateral metastasis group (P < 0.05). Significant differences lied between N0 group and N2 group (P < 0.05). Moderate and severe invasion of contralateral semilarynx in the bilateral group made up 87.5% (14/16), significantly higher than that in ipsilateral group 53.3% (16/30).


CONCLUSION
Bilateral neck dissection should be used in T4 cases with low grading of cell differentiation in which the contralateral semilarynx was invaded. Bilateral neck dissection should be taken for the treatment of supraglottic carcinoma with N2.3 diseases. Bilateral neck dissection is recommended for the patients with moderate and severe invasion of the contralateral semilarynx.