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05). The prognosis of patients with lymph node metastases was significantly worse than that of negative patients (P0.05). On multivariate logistic regression, supraglottis cancer, tumor size 5cm and grade 3-4 classification were associated with significantly greater odds of lymph node metastasis. The nomogram showed favorable predictive efficacy and good calibration (in the training cohort C-index=0.700; in the validation cohort C-index=0.721). For elderly patients with T3-T4 laryngeal cancer, LND did not bring signific