Work

Axillary metastases following total laryngectomy: an under-recognised pathway

Year: 2026

Type: article

Abstract: OBJECTIVES: Axillary lymph node metastases represent a rare and under-recognised pattern of disease progression in laryngeal squamous cell carcinoma, with limited data regarding their timing and clinical significance. METHODS: We retrospectively reviewed all patients treated for advanced-stage laryngeal squamous cell carcinoma at two tertiary medical centres between 2017-2022, identifying cases that subsequently developed axillary lymph node metastases. RESULTS: Five patients (3.6 per cent) developed axillary lymph node metastases, all following total laryngectomy, four after salvage surgery for recurrent disease. Mean interval from surgery to axillary lymph node metastases diagnosis was 9.9 ± 4.2 months. All tumours were moderately to poorly differentiated, and axillary involvement was frequently associated with mediastinal nodal disease. All patients received systemic therapy, including chemotherapy and/or immunotherapy, and three died of disease during follow-up. CONCLUSION: Axillary lymph node metastases occurred within a relatively narrow time window after total laryngectomy, suggesting a non-random metastatic pattern. Awareness of this pathway is important for post-laryngectomy surveillance and interpretation of follow-up imaging.

Source: The Journal of Laryngology & Otology

DOI: 10.1017/s0022215126104836