Treatment discordance in the utilization of neck dissection for stage I-II supraglottic tumors

Head Neck. 2024 Jul;46(7):1589-1600. doi: 10.1002/hed.27736. Epub 2024 Mar 14.

Abstract

Background: In 2018, the National Comprehensive Cancer Network treatment guidelines began recommending the use of neck dissection during surgical management of stage I-II supraglottic laryngeal squamous cell carcinoma (LSCC).

Methods: Trends and factors associated with the use of neck dissection during larynx-preserving surgery for patients with cT1-2, N0, M0 supraglottic LSCC in the National Cancer Database (2004-2020) were evaluated using multivariable-adjusted logistic regression.

Results: Of the 2080 patients who satisfied study eligibility criteria, 633 (30.4%) underwent neck dissection. Between 2018 and 2020, the rate of neck dissection was 39.0% (114/292). After multivariable adjustment, academic facility type, undergoing biopsy prior to surgery, and more radical surgery were significant predictors of receiving neck dissection.

Conclusions: The results of this national analysis suggest that the utilization of guideline-concordant neck dissection for management of stage I-II supraglottic LSCC remains low and highlight the need to promote the practice of neck dissection for this patient population.

Keywords: elective neck dissection; guideline‐concordant treatment; laryngeal squamous cell carcinoma; larynx‐preserving surgery; supraglottic cancer.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Databases, Factual
  • Female
  • Humans
  • Laryngeal Neoplasms* / mortality
  • Laryngeal Neoplasms* / pathology
  • Laryngeal Neoplasms* / surgery
  • Laryngectomy / methods
  • Male
  • Middle Aged
  • Neck Dissection*
  • Neoplasm Staging*
  • Retrospective Studies
  • United States