Incidence of metastasis to level V lymph nodes in clinically positive necks among Sri Lankan patients with oral squamous cell carcinoma (original) (raw)
Related papers
Lymph nodes assessment of neck in oral squamous cell carcinoma and its implication in management
International Journal of Applied Dental Sciences, 2020
Background and Aim: This study was conducted to find the correlation between clinically palpable neck nodes and their histopathological examination results which gives some information to the clinician regarding the choice of treatment and for appropriate management of the neck. After the surgical procedure, the whole specimen was submitted for the histopathological examination and a correlation between clinical positive or negative nodes and their histologically confirmed malignancies were drawn. Materials & Methods: A total of 200 patients with the diagnosis of oral malignancy subjected to oral and maxillofacial surgery department and institute of oncology over the period of 2 years were included in the study. Once the confirmation by histopathology was done, routine blood investigation, HIV/HBSAg test, ECG was done and physician's consent was taken prior to surgery under general anaesthesia. Pre-operatively thorough clinical palpation of the five levels of cervical lymph nodes was performed bilaterally. Results: On clinical examination of lymph nodes by palpation in 200 cases, 50 sides of necks were negative for palpation and 162 sides of necks were positive for palpation. On the histopathological examination of neck dissections, 8 of necks were positive. That is 46 cases were true positive that the histopathology showed no metastasis and 8 cases were false positive which showed metastasis in histopathology. Conclusion: Histopathology examination with its ability to detect 100% metastases in cervical lymph nodes remains the gold standard. Even though, Clinical examination was and is still the routine first line in detecting cervical lymph node metastases in head and neck squamous cell carcinoma, Its use shall be restricted for only an initial evaluation of the patient.
Patterns of Neck Node Metastasis in Carcinoma of Oral Cavity
Bangladesh Journal of Otorhinolaryngology, 2020
Objectives: To find out the patterns of cervical lymph node metastasis in oral cavity carcinoma. Methods: This is across sectional study which was carried out in the department of Otolaryngology & Head Neck Surgery Dhaka Medical College Hospital (DMCH), Sir Salimullah Medical College Hospital (SSMC), Bangabandhu Sheikh Mujib Medical University (BSMMU) and National Institute of Cancer Research & Hospital (NICRH) from July 2013 to December 2014.Total 96 cases were included in this study. Data were collected by detail history, clinical examination, relevant investigation and result were processed manually and analyzed with the help of SPSS. Results: In this study 72 (75%) patients presented with clinically palpable neck nodes and 24 (25%) presented without neck node. Among 24 cases 7 cases was radiologically positive neck node. Out of 96 cases stage III was the highest (50.96%) followed by stage IV (27.01%), stage II (13.52%) and stage I (8.32%). That is 23 (23.92%) patients present wi...
2014
Introduction: Squamous cell carcinoma represents about 90% of malignancies of the mouth and about 38% of the head and neck tumors. The behavior of the cancer is very aggressive, presenting early cervical metastasis and, often contralateral ranging from 0.9 to 36%. Objectives: This study aims to analyze clinical and pathological factors that may influence metastasis of squamous cell carcinoma in cervical lymph nodes and relate this occurrence in the contralateral primary tumor, with disease prognosis and the interference of this type of metastasis in the survival rate of patients with this pathology. Material and Metohds: It was conducted a retrospective study from medical records of patients with Squamous Cell Carcinomas with homolateral lymph node metastasis and contralateral attended at the clinic of Head and neck surgery of Hospital São Vicente de Paulo in Passo Fundo -RS -Brazil, from 2000 to 2008. Results: Analyzing the charts of patients with metastatic and metastatic contralateral side it was observed that patients with initial stage presented a higher survival with statistical significance (p=0,035). Conclusions: The occurrence of metastases in lymph nodes of contralateral position to the primary lesion was not the main fator that influenced the survival of the group.
Ibnosina Journal of Medicine and Biomedical Sciences, 2010
Introduction: Cervical node metastasis in oral cancer is an indicator of advanced disease. It is therefore important to evaluate neck node involvement as a predictor of progression and treatment planning.Materials & Methods: Eleven patients with age range between 38 to 63 years (median age 54 years) undergoing neck dissection simultaneously with the resection of primary intraoral squamous cell carcinoma formed the basis of the present study. A pre-operative assessment of neck by clinical examination, ultrasonography and computed tomography scan was done, which was then compared to the histopathological assessment. The histopathological examination formed the reference.Results: The percentage of sensitivity by clinical examination was 46%. The percentage of sensitivity by ultrasonogram was 69%. The percentage of sensitivity by computed tomography (CT scan) was 85%. These were against the histopathological examination.Conclusion: The study reported an error of almost 50% for the clini...
Patterns of Neck Nodal Metastasis from Oral Cavity Carcinoma
South Asian Journal of Cancer
Objectives The aim is to study the patterns of lymph node metastasis from various sites in oral cavity cancer and determine the risk factors for metastasis. Materials and Methods It is a prospective observational study. The inclusion criteria were—245 patients of carcinoma buccal mucosa, anterior two-thirds of tongue, hard palate, oral surface of soft palate, floor of mouth, vestibule, and alveolus. The exclusion criteria were—patients who had received preoperative chemotherapy or radiotherapy and patients with recurrent disease. Statistical Methods All data were analyzed using SPSS 18.0 and Graphpad prism 7 software for statistical analysis. Count data have been expressed as percentages (%). The χ 2 test was used for univariate analysis of the risk factors of cervical lymph node metastasis. The odds ratio value (with 95% confidence interval) was used to express the risk of cervical lymph node metastasis. p-Value of <0.05 was considered as the difference with statistical signific...
Journal of Maxillofacial and Oral Surgery, 2010
Background The presence or absence of nodal metastasis has a great impact on the prognosis and survival of patients with head and neck cancer. The risk of occult metastasis is related to the method by which the lymph nodes are evaluated. It is possible to reduce the risk of undiagnosed metastasis with accurate imaging techniques and thus probably reduce the number of elective neck treatments. Aims and objectives To assess the accuracy of clinical palpation, CT Scan, Ultrasound and Ultrasound guided FNAC in prediction of lymph node metastasis in oral squamous cell carcinoma so that a suitable surgical neck dissection can be carried out. Methods Ten patients with oral squamous cell carcinoma who underwent 10 neck dissections (4 RND, 6 SOND) were included. All the patients underwent examination of neck pre operatively by palpation, Computed Tomography with contrast, Ultrasound and Ultrasound guided FNAC for no detection. The findings were correlated with the results of histopathologic examination of the neck specimen. The results were obtained after statistical analysis. Results Six neck dissection specimens showed metastatic lymph node involvement in postoperative histopathology. Lymph node involvement was identified preoperatively by palpation in 7 necks, CT in 3 necks, US in 9 necks and US-FNAC was positive in 4 cases. The palpation showed 83% sensitivity, 50% specificity. CT showed sensitivity of 50%, specificity of 100%, US showed sensitivity of 100%, specificity of 25% and US-FNAC showed sensitivity of 67%, specificity of 100%. Conclusion The palpation, CT Scan and US are equally accurate but the US-FNAC is the most accurate technique in assessing metastasis in lymph nodes in patients with oral squamous cell carcinoma.
A Study on Secondary Neck Nodes from Squamous Cell Carcinoma of the Head and Neck Region
AIM: To find out the incidence of cervical node metastases on clinical examination in squamous cell carcinoma of the head and neck region. To find the incidence of cervical nodal metastases commonly involved according to the primary tumour at the time of presentation. To describe the distribution of cervical node metastases by the site of the primary tumour. To correlate individually the size of the tumour and cervical nodal metastases. To correlate individually the degree of histopathological differentiation of tumour and cervical nodal metastases. METHODS: The materials used in the study consisted of 60 cases of histologically proven squamous cell carcinoma in the head and neck region which were admitted in all surgical wards of Government Mohan Kumaramangalam Medical College and Hospital, Salem during June 2018-June 2020. RESULTS: Males are predominantly affected by squamous cell carcinoma of head and neck region. 75% of patients had nodal metastasis at the time of admission. Posteriorly situated tumours displayed greater propensity of nodal metastases than anteriorly situated tumours. Carcinoma arising in the buccal mucosa, alveolus, floor of mouth, hard palate and maxillary antrum predominantly metastasized to the submandibular nodes, whereas those arising in the tongue (both anterior 2/3rd and posterior 1/3rd), tonsils and soft palate predominantly metastasized to the upper deep cervical group. A progressive increase in the incidence of node metastases was observed with increasing tumour size. A progressive increase in the incidence of node metastasis was observed with increasing histological undifferentiation of the tumour. CONCLUSION: Males are predominantly affected by squamous cell carcinoma of head and neck region. 75% of patients had nodal metastasis at the time of admission Site of the primary appeared to influence the incidence of regional nodal metastases. Posteriorly situated tumours arising in the oropharynx (base of tongue, tonsils, soft palate) displayed a greater propensity for regional metastases(66% to 100%) as compared to anteriorly situated tumours arising in the oral cavity(33% to 83%). Amongst the posteriorly situated tumours, carcinoma of the tonsils showed the highest incidence of nodal metastases(100 percent). Amongst the anteriorly situated tumours, carcinoma of buccal mucosa showed the highest incidence of node metastases (83.33%). The large primaries (more than 4cm) and those with higher histologic grade (moderate to poorly differentiated) have a greater propensity for developing regional nodal metastasis.
Ear, Nose & Throat Journal, 2012
Cervical lymph node metastasis is the most important prognostic factor in patients with head and neck carcinoma. We retrospectively analyzed the effects of three different variables—tumor size, degree of differentiation, and depth of invasion—on the risk of neck node metastasis in 50 adults who had been treated with surgery for primary squamous cell carcinoma of the oral cavity. Primary tumor depth and other pathologic features were determined by reviewing the pathology specimens. Preoperatively, 36 of the 50 patients were clinically N0; however, occult lymph node metastasis was found in 13 of these patients (36.1%). The prevalence of neck node metastasis in patients with T1/T2 and T3/T4 category tumors was 51.5 and 58.8%, respectively. The associations between the prevalence of neck node metastasis and both the degree of differentiation and the depth of invasion were statistically significant, but there was no significant association between neck node metastasis and tumor size. We ...