TREATMENT OF CERVICAL LYMPH NODE METASTASIS FROM PRIMARY LESIONS OF THE OROPHARYNX, SUPRAGLOTTIC LARYNX AND HYPOPHARYNX

¹ From the Department of Radiotherapy and Section of Head and Neck Surgery, The University of Texas, M.D. Anderson Hospital and Tumor Institute at Houston, Houston, Texas

The records of 291 patients with cancer of the oropharynx, supraglottic larynx and hypopharynx in whom radical neck dissection was performed were reviewed. There was failure to control the cancer in the neck in 30 of 146 patients (20 per cent) who had radical neck dissection alone. In 145 patients receiving radiation therapy either prior or subsequent to the neck dissection, there was a failure to control the cancer in the neck in 22, or 15.2 per cent. The addition of radiation therapy to radical neck dissection does not improve the results in those patients with single ipsilateral lymph nodes less than 3 cm. in diameter (N₁); however, almost 50 per cent improvement (32.4 per cent recurrence versus 17.0 per cent recurrence) is obtained by adding radiation therapy to radical neck dissection in patients with multiple, fixed, or bilateral cervical metastasis (N₂ and N₃,).

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