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The treatment results and histologic findings in the cervical lymphatics of 96 patients with quamous cell carcinoma of the supraglottic larynx were studied retrospectively. The clinical assessment of the extent of disease in the cervical lymphatics correlated poorly with histologic findings. Forty-one percent of patients judged to have no evidence of cervical metastases were found to have carcinoma in the cervical lymphatics. Twenty percent of patients judged clinically NO were found to have extracapsular spread of tumor. Patients were subdivided according to the histologic findings in the cervical lymphatics. Three-year no-evidence-of-disease (NED) follow-up was available on all patients. Patients with no tumor in cervical lymphatics had a 71% 3-year NED. By comparison, patients with cervical metastases confined to the lymph node were 79% NED. Patients with histologic evidence of extracapsular spread of tumor were 45% NED (P < 0.05). The use of histologic findings in predicting prognosis and treatment planning is discussed. Comer 5 6 I 597-1599, 1985. XTRACAPSULAR SPREAD Of Cancer in cerViCa1 lymph E nodes (ECS) has been proven to be a reliable prog-nostic indicator in dealing with squamous cell carcinoma of the head and neck.',' There is not always a correlation between the size of the lymph node and the presence of extracapsular spread. The TNM staging system was originally designed to provide guidance for the head and neck surgeon in counseling patients and in selecting therapeutic programs. Identification of factors that correlate

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