Abstract
The relationship between mode of cervical lymph node metastasis and prognosis of 242 patients who underwent neck dissection (ND) with squamous cell carcinoma of the oral cavity from 1974 to 1993 were investigated. Three hundred NDs were performed and cervical lymph node metastases were histologically identified in 176 cases. The average of the metastatic nodes in the 176 pN (+) cases was 2.4, the extracapsular spread was seen in 62 cases (35%), and the spread of metastatic node was present as far as level III in 85%.
The rate of neck recurrence was 10.5 % in the pN (+) cases whose primary lesions had been controlled. The rate of distant metastasis was 23.5 % in the pN (+) cases whose primary and neck lesions had been controlled, and the incidence of distant metastasis was 41.7 % in patients who had more than 2 metastatic lymph nodes. The number and the level of metastatic lymph nodes were significantly related to the 5-year cumulative survival rate. Furthermore, as to cases whose primary and neck lesions had been controlled, the 5-year survival rate was 50.9 % and 50.5 % in patients who showed the metastatic lymph node of more than 2 and level N or V, respectively.
These result suggested that the postoperative strategy such as radiation therapy for the neck and/or adjuvant chemotherapy may be necessary to improve the prognosis of the patients who showed metastatic lymph nodes of more than 2 or level IV and/or V.
