Abstract
We use CT, MRI, and ultrasound-guided fine needle aspiration cytology for the neck examination of all cases with head and neck cancer. From 1997 to 2001, the occult metastasis rate to the ipsilateral neck was 27% for T1/2 tongue cancer, 36% for T3/4 tongue cancer, 28% for T3/4 laryngeal cancer, and 47% for T3/4 hypopharyngeal cancer. The occult metastasis rate to the contralateral neck was 8% for stage III/IV tongue cancer and 15% for T3/4 hypopharyngeal cancer. The overall metastasis rate to the area of ipsilateral level I, II, III, IV, and V was 45%, 55%, 33%, 7 %, and 4 % respectively for stage III/IV tongue cancer, and was 0 %, 47%, 39%, 21%, and 6 % respectively for hypopharyngeal cancer. The disease-free rate was 91% for the cases with T1/2 tongue cancer who did not have elective neck dissection. Elective neck dissection should be indicated on the basis of these data.
