A Study on Secondary Neck Nodes from Squamous Cell Carcinoma of the Head and Neck Region (original) (raw)
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.
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