Lymph node metastases of malignant tumors of the palate

Abstract

In this study on the localization of lymph node metastases of malignant tumors of the palate, a restrictive anatomical criterion has been adopted, with exclusion of the tumors of the gums, of the fornix, and of the glossopalatine and pharyngopalatine pillars. Basing on this criterion, 103 cases of malignant tumors of the palate were found among 3498 tumors of the oral cavity. Of the 103 cases, 40.77 percent were tumors of the vault, 44.66 percent of the velum, and 14.56 percent of the palate in toto. At the first visit, lymph node metastases were noticed in 74.7 percent of the cases. There was monolateral involvement of the Küttner's lymph node in 27.3 percent of the cases, bilateral in 32.4 percent; monolateral involvement of the internal jugular chain in 7.8 percent; simultaneous involvement of the two lymph node stations monolaterally in 22.1 percent of the cases, bilaterally in 10.4 percent. With regard to the site of development of the tumors, the Küttner's lymph node was involved bilaterally in 70 percent of the tumors of the palate in toto and in 35.7 percent of the tumors of the hard palate, while in the tumors of the soft palate it was involved monolaterally in 30.8 percent of the cases and bilaterally in 20.5 percent. The lymph nodes of the internal jugular chain were always involved monolaterally in 10 percent of the cases irrespectivly of the site of origin of the tumor. The simultaneous involvement of the Küttner's lymph node and of the internal jugular chain was observed in 14.3 percent of the tumors of the hard palate, either mono- or bilaterally; in the tumors of the soft palate the monolateral localization prevailed (30.8% versus 10.2%). On the whole it was found that the tumors of the hard palate too have a high propensity to give metastases (66.7%). The survival rate over 5 years was studied in 55 cases and it was found to be significantly higher in the cases with involvement of the Küttner's lymph node only, either monolaterally (36.4%) or bilaterally (31.2%).