Evolution of neck disease in patients with primary squamous cell carcinoma of the oral tongue, floor of mouth, and palatine arch, and clinically positive neck nodes neither fixed nor bilateral.

Abstract

The evolution of neck disease in 180 patients with controlled squamous cell carcinomas of the oral tongue, floor of the mouth, and faucial arch having initially clinically positive nodes neither fixed nor bilateral has been analyzed by modality of treatment of the neck disease, i.e., radical neck dissection, combined radical neck dissection and irradiation, and irradiation. There is a shift to earlier primary lesions and less extensive neck disease in the patients having had a radical neck dissection only. In addition to less recurrences in the radically dissected neck, there was diminution in the development of contralateral nodes from 34% in the patients with radical neck dissection only to 4%in the patients having had the combined treatment or irradiation only. Contralateral metastases almost always appear in the opposite subdigastric area. Doses from 3,000 rads in 3 weeks to 5,000 rads in 5 weeks were given to the opposite subdigastric area in the patients having had the combined treatment or irradiation.