【Objective】 To explore the impact of cervical metastasis on the survival of patients with advanced laryngeal squamous cell carcinoma. 【 Methods】 Between January 1990 to December 2005

312 cases of squamous cell carcinoma of the larynx hospitalized in Cancer Center

Sun Yat-sen University were reviewed retrospectively. 141 patients (45.2%) had positive clinical cervical nodal disease (cN+) and 171 patients (54.8%) had negative clinical cervical nodal disease (cN0) at initial presence. Survival differences according to presence or absence of clinical cervical nodal disease and N-stage were determined with Kaplan-Meier method and the log-rank test. 【Results】 The 5-year survival rates for cN+ patients and cN0 were 33.7% and 60.5% (P < 0.001). The 5-year survival rates were 40.6%

33.6%

and 0% for cN1~cN3 lesions

respectively (P < 0.001). Clinical cervical metastasis was detected in 45.2% (141/312 cases) of those individuals with advanced laryngeal squamous cell carcinoma presenting for initial clinical consultation; after therapy

those cN+ patients (141 cases) all had positive histological cervical metastasis and 30 cases (30/171

17.5%) of those cN0 individuals had positive histological cervical metastasis. Finally

54.8% (171/312) of our patients with histologically positive necks manifested disease to the cervical lymph nodes. 【Conclusion】 The patients presence of cervical nodal disease associated with decrease survival rate. Besides

advanced N-stage significantly correlated with worse prognosis. The cervical lymphy node of advanced laryngeal squamous cell carcinoma should be treated aggressively.