Abstract
Prognosis is extremely poor for cases involving lateral retropharyngeal lymph nodes (RPN, so-called Rouviere lymph nodes) with oral squamous cell carcinoma (SCC) . This report concerns an assessment of patients with metastatic RPN and of therapeutic results for RPN metastases. Five patients with SCC arising from the oral mocosa and who were treated at our department during the past 10 years showed positive RPN. The primary sites consisted of two buccal mucosas, one upper alveolus and gingiva, one tongue, and one floor of the mouth. These five patients with positive RPN represented only 1.5 % of the 338 patients with oral SCC, including recurrence, seen at our department during the past decade. RPN metastases were seen in only two (0.6%) of 326 previously untreated patients, but in three (25.0%) in 12 recurences. Out of the four recurrences who underwent a therapeutic neck dissection as secondary treatment, three (75.0%) with RPN metastases had been given external irradiation during previous treatment. Two of five the patients with metastatic RPN had no recurrence at RPN sites. One of them underwent RPN dissection and one patient was treated with conformation radiotherapy, and both are alive without disease. During the same period, elective RPN dissection after preoperative radiotherapy was added to the thrapeutic program for seven selected patients with advanced oral SCC, but none of them had positive RPN. However, active dissection of RPN and/or high dose irradiation should be performed where necessary as indicated by diagnostic imaging.
