Predictive parameters for cervical lymph node metastasis in laryngeal squamous cell carcinoma

Abstract

Background Laryngeal carcinoma represents the most common malignancy in otolaryngological surgical practice, accounting for about one-third of all malignancies of the head and neck region. The presence of lymph node metastasis (LNM) is considered the most important predictor of survival in head and neck squamous cell carcinomas, including laryngeal cancer. Objectives In this study, we aimed to identify histopathological and radiological parameters associated with LNM in laryngeal squamous cell carcinoma (LSCC). Patients and methods This retrospective study included a total of 89 cases of LSCC who underwent laryngectomy and neck dissection in Ain Shams University Hospital. A collection of clinicoradiologic and histopathologic data, as well as a review by two independent pathologists, was done. Results In univariate analysis, radiologic evidence of thyroid cartilage involvement, pathologically proven bilaterality, larger tumor size, grade, stage, lymphovascular and perineural invasion, and margin positivity were significantly associated with LNM ( P =0.037, P =0.011, P =0.034, P =0.004, P =0.005, P <0.00001, P =0.004, and P =0.02, respectively). Using multivariate analyses, tumor bilaterality, T stage, and perineural invasion were found to be independent risk factors for LNM, with T stage being the most significant predictor. Conclusion This study found that the most important histopathologic parameters related to cervical LNM from primary LSCC cases include tumor bilaterality, size, histologic grade, lymphovascular invasion, perineural invasion, margin clearance, and tumor stage. Radiologic evidence of thyroid cartilage invasion was also considered an independent risk factor.