PATTERN OF NECK LYMPH NODE METASTASIS AND FACTORS AFFECTING THE LYMPH NODE METASTASIS IN SQUAMOUS CELL CARCINOMAS OF HEAD AND NECK

Abstract

Background: Head and neck cancer exhibits metastases to cervical lymph nodes through certain lymphatic drainage routes. The 5-year survival rate for patients with neck metastases reduces depending on the number and level of nodes involved. To assess the patterns of lymph Objective: node metastasis for squamous cell carcinoma of head and neck and analyse the prognostic factors of cervical node status and highlight their effect on treatment and prognosis. The study entailed a cross sectional analysis of Method: 66 patients with squamous cell carcinoma of head and neck radiologically or pathologically proven. Data collected and was analysed by a chi square test using SPSS (version 20). Of the 66 clinically Results: node-positive patients, 18 had bilateral lymph node metastasis and 48 had ipsilateral LNM. In all primary sites pattern of lymph drainage was followed except for in 1 case of carcinoma larynx where metastasis was to level II and IV without involvement of level III. We Conclusion: concluded majority of the HNSCC cases followed normal pattern of drainage and in individuals with oral cavity and oropharynx SCC, the incidence of bilateral neck LNMs are high particularly to level II of contralateral side. With higher stage of the disease and long duration of symptoms chances of lymph node metastasis is high thus worsening the prognosis. Bilateral neck dissection is recommended for primary surgical treatment, with the exception of early stages, when ipsilateral neck dissection may be performed