Prognostic value of Delphian lymph node in T1b glottic carcinoma

Background: The published papers concerning Delphian lymph node (DN) involvement in laryngeal tumours generally consider advanced laryngeal and hypopharyngeal cancer. We investigated the role of DN in a selected group of patients with T1b glottic squamous cell carcinoma. Materials and Methods: The study involved 53 patients with T1b glottic squamous cell carcinoma who underwent horizontal glottectomy. DN was isolated in 46 (86.8%). Histological evaluation of the isolated nodes revealed the presence of metastases in three cases (6.5%). Results: Forty-six of the 53 patients (86.8%) are still alive and disease-free; four (7.5%) died because of their disease and three (5.7%) because of unrelated causes. The 3- and 5-year overall survival was, respectively, 94.3% and 90.6%. Both the 3- and 5-year disease-free survival was 92.5%. Two of the three patients with a metastatic DN died because of a recurrence: laterocervical lymph node metastases in one case and parastomal recurrence in the other. The frequency of local relapse was at the threshold of significance in the patients with a positive DN (p=0.0540). Of the four patients who died of their disease, two were DN-positive. Mortality was statistically higher in the DN-positive patients (p=0.0166). Conclusion: The presence of DN metastases was statistically associated with recurrence and overall survival in T1b glottic cancer.