Diagnostic and Therapeutic Study of the Neck Metastasis of Oral Squamous Cell Carcinoma

Abstract

The control of cervical lymph node metastasis is an important prognostic factor in patients with oral squamous cell carcinoma (SCC). Determining whether neck dissection is indicated before initial treatment is essential for improving the success rate and maintaining patients' quality of life. However, criteria for elective neck dissection remain undecided. In this study, we analyzed the predictive factors for cervical lymph node metastasis in 256 patients undergoing treatment for oral SCC at the Department of Oral and Maxillofacial Surgery, Gunma University Hospital. Cervical lymph node metastasis was present in 29.3% of the patients. Prevalence was not significantly correlated with primary sites or T stages. In histopathological findings for the SCC cells, cervical metastasis was observed more in cases of poorly differentiated type or infiltrative growth pattern (INF) c than for other types or patterns, and the odds ratio of metastasis was 6.96 or 4.80, respectively. For patients with cervical metastasis, plural metastatic nodes involved in plural levels with extracapsular invasion were observed more for INF c than for INF a-b. In INF c cases, the survival rate of patients with resection of the primary site and neck dissection simultaneously was higher than that of patients with secondary neck dissection after metastasis. These results suggest that elective neck dissection is applicable in cases of INF c because of a potential link to cervical lymph node metastasis.