# Incidence of contralateral cervical metastasis in laryngeal tumors

## TL;DR

The study finds that contralateral neck dissection is rarely needed for laryngeal cancer patients with no visible metastasis on the opposite side.

## Contribution

The study provides evidence against routine bilateral neck dissection in cN0 cases, except for advanced T4 tumors.

## Key findings

- Only 12.73% of patients with bilateral dissection had contralateral metastasis.
- Patients with contralateral cN− have less than 20% risk of hidden metastasis.
- Bilateral dissection is mainly recommended for T4-stage laryngeal tumors.

## Abstract

•The rate of contralateral metastases in supraglottic cancer is low.•Routine bilateral neck dissection is not recommended when the other site is cN0.•We still consider bilateral neck dissection only for T4 lesions.

The rate of contralateral metastases in supraglottic cancer is low.

Routine bilateral neck dissection is not recommended when the other site is cN0.

We still consider bilateral neck dissection only for T4 lesions.

To evaluate if patients with laryngeal SCC homolateral cN+ and contralateral cN− should be submitted to bilateral neck dissection.

The team reviewed medical records from 135 patients with a diagnosis of laryngeal malignancy between March/2009 and September/2017, analyzing gender, age, tobacco and alcohol comsumption, primary tumor site, neck dissection laterality, clinical and pathological contralaterality, staging, tumor recurrence or late metastasis and survival

We observed that 40.74% were pN+ on at least one side after neck dissection, which 87.27% performed bilateral neck dissection. Of these, 66.67% did not have contralateral metastasis, 87.5% had no previously clinically evident metastasis.

Patients contralateral cN− have a risk <20% for occult metastasis and should not routinely go through bilateral neck dissection.

Level III.