Clinical significance and surgical management of regional lymph nodes in oral cancers - a review of English literature up till July 2001

Abstract

Regional lymph node metastases is found in about 6-85 per cent of all patient with carcinoma in the head and neck region. It is also widely accepted that lymph node metastases is the single most important predictor of survival in patient with squamous cell carcinoma of the oral cavity. The present review was undertaken to provide practitioners managing oral cancers in the sub-region an update on developments in the clinical significance and management of regional lymph node metastases in oral mucosa squamous cell carcinoma. This review is primarily based on articles selected from MEDLINE concerning regional lymph nodes metastases of oral squamous cell carcinoma up to July 2001. Characteristics of metastatic lymph node such as number of positive nodes, histological features, extracapsular spread and location in the neck significantly affect the prognosis of oral squamous cell carcinoma in individual patient more that most other parameters that are usually considered in the surgical management of such lesion. Prognosis of oral mucosa squamous cell carcinoma to a large extent depend on the status of regional lymph nodes however, the management of such node varies in different center. Conservative approach such as supraomohyoid neck dissection is currently widely accepted as the method of management in No and some selected N1 neck in oral squamous cell carcinoma.