{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:56:36Z","timestamp":1784033796370,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Early\u2010stage glottic cancer (cT1\u2013T2 cN0) may be treated by primary surgery or radiation. Elective treatment of the neck in clinically N0 disease is usually not performed due to low rates of regional lymph node metastasis. This study examines the role of elective neck dissection (END) and rate of occult nodal metastasis in cT1\u2013T2 cN0 glottic cancer treated with primary surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The National Cancer Database was used to identify patients treated for early\u2010stage glottic cancer. Demographic variables, disease characteristics, and overall survival were compared between the subgroups of patients who did and did not receive END. Factors predictive of occult lymph node metastasis were also identified using a multivariate logistic regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010eight percent of the 991 patients in this cohort underwent END. Younger age, treatment at an academic facility, advanced T\u2010stage, and higher tumor grade were associated with receiving END. Sixteen percent of the 372 patients undergoing END had occult nodal metastasis. Higher tumor histopathologic grade was associated with occult metastasis (<jats:italic>P<\/jats:italic> =\u2009.004). While undergoing END did not affect significantly survival, those with occult metastasis had poorer survival (<jats:italic>P<\/jats:italic> &lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>END should be considered in cT1\u2013T2\u2009N0 glottic cancers with poorly differentiated or undifferentiated tumor histopathology. While END itself may not improve overall survival, identification of occult nodal metastasis is an important finding for prognostication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level 3 <jats:italic>Laryngoscope<\/jats:italic>, 131:E1139\u2013E1146, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28995","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T05:12:11Z","timestamp":1598591531000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Occult Lymph Node Metastasis in Early\u2010Stage Glottic Cancer in the National Cancer Database"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2478-5282","authenticated-orcid":false,"given":"Tirth R.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rush University Medical Center  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8491-9126","authenticated-orcid":false,"given":"Michael","family":"Eggerstedt","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rush University Medical Center  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaijeet","family":"Toor","sequence":"additional","affiliation":[{"name":"Rush Medical College  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby A.","family":"Tajudeen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rush University Medical Center  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inna","family":"Husain","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rush University Medical Center  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Stenson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rush University Medical Center  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer","family":"Al\u2010Khudari","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rush University Medical Center  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.1671"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24862"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2008.01.016"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12139"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816638085"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215113001400"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2460-x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000345"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2007.06.008"},{"key":"e_1_2_6_11_1","first-page":"CD002027","article-title":"Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer","volume":"12","author":"Warner L","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12790"},{"key":"e_1_2_6_13_1","unstructured":"Survival Rates for Laryngeal and Hypopharyngeal Cancers. 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