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Download development planning text on your kindle in. by s k duggal free download – For and For One – Courses – Items – Grand. and 22% in Caucasians and in that of Dong et al (45% in Caucasians and 30% in Chinese) reported that lymph node metastases were more common in men than in women \[[@B6],[@B15]\]. Some studies have shown that the frequency of lymph node metastasis is very low in estrogen receptor-positive cases (0% to 3%) \[[@B16]-[@B18]\]. Clinical studies have suggested that lymph node metastasis is not very common in laryngeal carcinoma, and a high recurrence rate (21% to 39%) and a low survival rate (12% to 30%) have been reported \[[@B19]-[@B21]\]. Lymph node metastasis may be influenced by many factors, such as tumor size, histologic type, differentiation, intratumoral vascular invasion, depth of invasion, status of the neck, and lymphovascular invasion \[[@B19],[@B22]-[@B25]\]. The factors that may cause local spread in laryngeal carcinoma are not fully understood. The importance of lymph node metastasis should be assessed in the context of risk stratification for laryngeal carcinoma.
On the basis of the results of the present study, we can divide patients into two groups: one in which lymph node metastasis occurs and one in which it does not. Although the number of cases in the second group was lower, cancer-related death occurred only in patients in the first group. Based on the results of multivariate analysis, nodal involvement was the only independent risk factor associated with cancer-specific survival.
The present study was performed with the known risk factors, including tumor size, depth of invasion, and lymph node metastasis. Some researchers have suggested that the degree of differentiation and the histologic type may be important risk factors \[[@B14],[@B19],[@B26]\]. Ead et al \[[@B27]\] suggested that an association between increasing grade and lymph node metastasis exists, although the degree of differentiation was not a significant independent risk factor in the present study. In contrast,