Abstract
Clinicostatistical study was made about 70 patients with squamous cell carcinoma of the oral cavity (including maxillary sinus and oropharynx) who underwent radical neck dissection between 1978 and 1987 in our department.
Metastasis to the cervical lymph nodes was histologically confirmed in 42 patients (60%). In 13 of the cases, late metastasis occurred. The carcinomas of the buccal mucosa most frequently metastasized to the regional lymph nodes because many of them invaded the surrounding tissues. The ratio of late metastasis was highest in carcinoma of the tongue. As to distribution of involved lymph nodes (UICC 1978), the majority were recognized in Level I and/or Level II. In only two cases, they were distributed in Level IV (supra clavicle nodes).
Twenty-five patients died of carcinoma. Uncontrolled cervical lymph nodes matastasis caused death in 7 cases. Clinical course of patients with advanced cancer (T 4, N 3), contralateral neck matastasis and involved lymph nodes in Level IV was not very good. Extra lymph node invasion related mainly to the recurrence rate of the matastatic tumor. A tendency was indicated that the prognosis was worse as the number of involved nodes, matastatic sites and lower level of cervical nodes increased.
The comulative five-year-survival rate was 60.1% in patients without metastasis and 54.4% with metastasis. Although there was no significant difference between them, that of patients with late metastasis was extremely poor (14.4%). 7 cases of these patients were dead and moreover distant matastasis was recognized in 6 cases.
Up to date, the needling irradiation therapy in carcinoma of the tongue and therapeutic radical neck dissection was performed in our clinic. Late cervical metastasis after treatment for primary tumor seemed to be controlled by careful follow-up. However, according to the results, prophylactic neck dissection should be considered especially in high grade malignant tumors.
