Background: When the primary tumor in the larynx or hypopharynx responds well to radiotherapy, nodal metastasis in the neck may persist or recur. The primary site is usually left alone when no lesion is evident, but its long-term control is uncertain.
Methods: Radical neck dissection was performed in 23 patients who had nodal metastasis, while the primary tumor in the larynx or hypopharynx was controlled after radiotherapy. The primary site was left alone and kept under surveillance.
Results: Seven patients (30%) had recurrence at the primary site on follow-up. Two significant risk factors for development of recurrences at the primary site were identified; the neck node staging at presentation (p < 0.03) and presentation with persistent neck lymph nodes (p < 0.03). The 2-year survival of those patients with recurrences at the primary site was 29%.
Conclusion: Radical neck dissection alone was justified, but close surveillance of the primary site after surgery is mandatory, especially for those patients with high-risk factors.