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Isolated perifacial lymph node metastasis in oral squamous cell carcinoma with clinically node‐negative neck
Author(s) -
Agarwal Sangeet Kumar,
Arora Sowrabh Kumar,
Kumar Gopal,
Sarin Deepak
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25954
Subject(s) - medicine , neck dissection , tongue , lymph node , incidence (geometry) , buccal administration , cancer , metastasis , occult , epidermoid carcinoma , pathological , oncology , radiology , pathology , dentistry , physics , alternative medicine , optics
Objectives/Hypothesis The incidence of occult perifacial nodal disease in oral cavity squamous cell carcinoma is not well reported. The purpose of this study was to evaluate the incidence of isolated perifacial lymph node metastasis in patients with oral squamous cell carcinoma with a clinically node‐negative neck. The study will shed light on current controversies and will provide valuable clinical and pathological information in the practice of routine comprehensive removal of these lymph node pads in selective neck dissection in the node‐negative neck. Study Design Prospective analysis. Methods This study was started in August 2011 when intraoperatively we routinely separated the lymph node levels from the main specimen for evaluation of the metastatic rate to different lymph node levels in 231 patients of oral squamous cell cancer with a clinically node‐negative neck. Results The current study demonstrated that 19 (8.22%) out of 231 patients showed ipsilateral isolated perifacial lymph node involvement. The incidence of isolated perifacial nodes did not differ significantly between the oral tongue (7.14%) and buccal mucosa (7.75%). Incidence was statistically significant in cases with lower age group (<45 years), advanced T stage, and higher depth of tumor invasion. Conclusions Isolated perifacial node metastasis is high in oral squamous cell carcinoma with a clinically node‐negative neck. The incidence of isolated perifacial involvement is high in cases of buccal mucosal and tongue cancers. A meticulous dissection of the perifacial nodes seems prudent when treating the neck in oral cavity squamous cell carcinoma. Level of Evidence 4 Laryngoscope , 126:2252–2256, 2016