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Peer-reviewedCC BY 4.0The Journal of Laryngology and Otology

Axillary metastases following total laryngectomy: an under-recognised pathway

  • Eyal Yosefof1,2,3
  • Ofir Zavdy1,2
  • Tara Coreanu1,2
  • Noga Kurman2,3
  • Hanna Bernstine2,4
  • Roee Noy5,6
  • Yotam Shkedy5,6
  • Amit Ritter1,2
6 affiliations
  1. 1Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center-Beilinson Hospital, Petah Tikva, Israel
  2. 2Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
  3. 3Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
  4. 4Department of Nuclear Medicine, Rabin Medical Center, Petah Tikva, Israel
  5. 5Department of Otorhinolaryngology and Head and Neck Surgery, Rambam Health Care Campus, Haifa, Israel
  6. 6Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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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.

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Cite

BibTeXRIS
BibTeX
@article{yosefof2026axillary,
  title = {{Axillary metastases following total laryngectomy: an under-recognised pathway}},
  author = {Eyal Yosefof and Ofir Zavdy and Tara Coreanu and Noga Kurman and Hanna Bernstine and Roee Noy and Yotam Shkedy and Amit Ritter},
  journal = {The Journal of Laryngology and Otology},
  year = {2026},
  month = nov,
  doi = {10.1017/s0022215126104836},
  url = {https://doi.org/10.1017/s0022215126104836},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Axillary metastases following total laryngectomy: an under-recognised pathway
AU  - Eyal Yosefof
AU  - Ofir Zavdy
AU  - Tara Coreanu
AU  - Noga Kurman
AU  - Hanna Bernstine
AU  - Roee Noy
AU  - Yotam Shkedy
AU  - Amit Ritter
PY  - 2026
DA  - 2026/11/06
JO  - The Journal of Laryngology and Otology
DO  - 10.1017/s0022215126104836
UR  - https://doi.org/10.1017/s0022215126104836
AB  - 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.
SN  - 0022-2151
SN  - 1748-5460
ER  -