Abstract
The correlation between patterns of cervical lymph node metastases and outcome of patient with oral squamous cell carcinoma was studied retrospectively. This study included 42 patients who underwent lymph node dissection, after referral to our clinic between January 1982 and December 1993, and histologically confirmed cervical lymph node metastases without local recurrence.
The results were as follows:
1. The patients with metastatic lymph nodes at only one level above the mid jugular group, those with 3 or less metastatic lymph nodes and extranodal spread to one node at most, and if the patients underwent preoperative chemo-and/or radiotherapy, those showing a histopathological effect of grade II b to IV according to Oboshi-Shimosato's grading system for metastatic lymph nodes had a better prognosis than other patients.
2. Among 42 patients, eleven patients died of cervical failure, seven patients died of distant metastasis, and the remaining twenty-four patients have survived without tumor.
3. The recurrence at cervical lymph node sites, the ipsilateral upper jugular lymph nodes and parapharyngeal nodes, or contralateral cervical lymph nodes were common in this series.
4. Patients with more than three histologically positive nodes were at higher risk for distant me-tastasis.
From these results, it was suggested that parapharyngeal dissection and bilateral neck dissection were required in some cases. Furthermore, in patients with more than three histologically positive node or with more than single extranodal spread, some adjuvant therapy should be applied.
