From the Guidelines

No, neck dissection is not always included in a functional laryngectomy.

The management of disease in the neck is critical for overall survival in patients with laryngeal cancer, and appropriate management of the neck is a key consideration in all larynx-preservation strategies 1.
Elective treatment of the neck is indicated in most cases of supraglottic cancer, and recurrence rates of approximately 30% can be expected if not performed 1.
For patients with clinically involved regional cervical nodes (N+) who have a complete clinical and radiologic imaging response after chemoradiation, elective neck dissection is not required 1.

Patients with T1, T2 laryngeal cancer should be treated initially with intent to preserve the larynx by using endoscopic resection or radiation therapy 1.
For patients with locally advanced (T3, T4) disease, organ-preservation surgery, combined chemotherapy and radiation, or radiation alone offer the potential for larynx preservation without compromising overall survival 1.
The decision to perform a neck dissection should be guided by the presence of viable disease, as determined by post-treatment imaging, such as PET scans, which have a high negative predictive value 1.

From the Research

The inclusion of neck dissection in a functional laryngectomy is a topic of debate among medical professionals, with some studies suggesting its benefits and others arguing against its routine use 2, 3, 4, 5, 6.
A study published in 2018 found that elective neck dissection during salvage laryngectomy may be beneficial in patients with advanced local disease at recurrence, but not in those with limited disease 5.
Another study published in 2019 recommended considering elective neck dissection at the time of salvage laryngectomy due to the limited complications and poor prognosis of regional recurrence after previous treatment 4.
However, a decision-analysis model published in 2013 suggested that elective neck dissection is not warranted during salvage total laryngectomy, unless the cure rate with neck dissection exceeds 82% 6.
The role of neck dissection in functional laryngectomy may depend on various factors, including the extent of the recurrent disease, the patient's overall health, and the potential risks and benefits of the procedure 2, 3, 4, 5, 6.

Elective neck dissection may improve survival in patients with locally advanced recurrent disease 5.
The incidence of complications is not significantly different between patients who undergo elective neck dissection and those who do not 4.
The overall survival is significantly higher for patients who undergo elective neck dissection 4.
The decision to perform elective neck dissection during salvage laryngectomy should be made on a case-by-case basis, taking into account the individual patient's circumstances and the potential risks and benefits of the procedure 2, 3, 4, 5, 6.