A clinical study of neck failure in patients with squamous cell carcinoma of the oral cavity

Abstract

A clinical study was made of 124 patients with squamous cell carcinoma of the oral mucosa who underwent neck dissection between 1980 and 1991, and the following results were obtained :
1. Two of 66 patients ended in neck failure who were intially N+ and underwent resection of the primary tumor and neck dissection simultaneously as initial treatment. These two showed high histologic malignancy and multiple, extended neck metastases.
2. Five of 21 patients ended in neck failure who were initially N+ and underwent interstitial irradiation to the primary tumor followed neck dissection. These five showed moderate or low histologic malignancy and localized neck metastasis initially, but the duration between radiotherapy and neck dissection was long.
3. Five of 29 patients ended in neck failure who were initially NO and underwent neck dissection when late neck metastasis occurred. These five showed moderate or low histologic malignancy but their late metastases were not detected until they were very advanced.
4. None of 8 patients ended in neck failure who underwent neck dissection when local recurrence occurred.
5. These results indicated that establishment of treatment methods for patients with high histologic malignancy and the early diagnosis of neck metastasis using CT and MRI were important.