Keywords: Larynx, cervical metastasis

Abstract: The purpose of this prospective study was to evaluate the pattern of the lymphatic spread in patients with laryngeal or hypopharyngeal squamous cell carcinoma treated at Head and Neck Surgery Service of the Heliópolis Hospital, São Paulo, Brasil, between 1981 and 1988. There were 173 patients included in this study and all of them were treated by surgery with a curative intent: laryngectomy and in block unilateral or bilateral comprehensive neck dissection. The surgical specimen was dissected in the operating room and the nodes were classified by anatomic chains according to Rouvière classification. In the N0 cases metastatic nodes were found in 27,0% and the jugular nodes were the most frequently involved. In N1 cases the nodal disease was confirmed in 86,1 % of cases and again the jugular groups of lymph nodes presented a higher rate of involvement in all of its leveis. The N2 and the N3 cases showed the same pattern of lymphatic dissemination. In this casuistic the contralateral nodes were positive in the first treatment in 10,4% of patients and in the follow-up, more 12,8 % of patients developed contralateral nodal disease. Based on this study the author concluded that the jugular nodes are time most frequently involved and the others chains rarely are positive isolately. The contralateral nodes should be investigated carefully and being removed even electively.