Abstract
The factors predisposing to bilateral cervical lymph node metastasis (BLNM) in squamous cell carcinoma (SCC) have not yet been clarified. We tried to explore the mechanism of BLNM from oral and oropharyngeal SCCs.
Of 583 patients with oral or oropharyngeal SCCs, 168 and 27 patients revealed unilateral lymph node metastasis (ULNM) /and BLNM, respectively. ULNMs were observed frequently in floor of the mouth (44.2%) and oropharyngeal SCCs (35.3%), while BLNMs were observed frequently in palatal (27.3%), oropharyngeal (11.8%), and upper gingival SCCs (11.5%) . Carcinomas involving the median region highly metastasized to bilateral lymph nodes compared with those involving the median region (p<0.05) . Both ULNM and BLNM were statistically associated with the advancement of T stage. In addition, there were relationships between the mode of tumor cell invasion and the incidence of ULNM and BLNM.
In two of 17 patients whose primary lesions did not involve the median region and that developed BLNM, ipsilateral neck dissections were done, and lateral lymph nodes metastases occurred after relapse of the primary lesions. In conclusion, these findings revealed that oral carcinomas involving the median region, and carcinomas in the hard palate, oropharynx, and upper gingiva having diffuse modes of tumor cell invasion, have a tendency toward BLNM. And the interception of the lymph vessels by neck dissection on the disease side may bring a risk of opposite side metastasis.
