Cervical lymph node metastatic patterns of squamous carcinomas in the upper aerodigestive tract

Abstract

The radical neck dissection specimens of 384 ethnically Chinese patients with different primary squamous carcinomas in the head and neck region were studied. Over 50 per cent of the specimens showed metastatic disease at one level in the neck. For oral cavity carcinoma, the levels of metastasis frequently involved were I, II and III while for carcinoma of the oropharynx, hypopharynx and larynx, the levels were II, III and IV. Extracapsular spread was present in 112/384 of patients (29 per cent) and this increased with advancing N-stages. Based on these findings, different selective neck dissections could be used for patients harbouring different primary head and neck carcinomas with limited neck disease.

A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck

“…In regions where hook worm infestation is rampant, the use of antihelminthics may also be protective against oral cancer as hook worm can cause chronic iron deficiency anaemia. Few reports exist on diet which may protect against oral cancers [90,93]. This includes eating of diet rich in fresh fruits and vegetables [91,94].…”

“…Researchers have demonstrated that clinical N0 necks have shown occult metastases in about 30% or higher, depending on the size, site of primary tumor and the histological diagnostic methods [21,118]. The great challenge that is being faced by the head and neck oncologists and surgeons is the correct identification of the subset of head and neck cancer patients, of which oral carcinoma constitutes about 30% [90], without micro metastases to the cervical lymph nodes. Clinical palpation of the neck combined with the radiological investigative tools has not been able to correctly identify all these patients [39,102,130].…”

“…It accounted for 30% of all head and neck cancers [90]. The rich lymphatic drainage in this region makes these tumors to show a high incidence of metastasis to regional cervical lymph nodes [30].…”

Paradigma da disseminação linfática no carcinoma espinocelular da base da língua

“…Em muitos casos a principal queixa que motiva o paciente a procurar o médico é a presença de linfonodos cervical.Grande parte dos enfermos chegam no ato da primeira consulta com o tumor primário avançado e com linfonodos metástaticos no pescoço 2,7,[14][15][16] . Nossos pacientes apresentavam-se no diagnóstico inicial com o tumor Devido à rica rede de drenagem linfática da base de língua, o carcinoma epidermóide apresenta uma alta incidên-cia de metástase regional, comportamento agressivo, mais freqüentes com o aumento do estadiamento (T) 2,9,15,17 . A precoce invasão do sistema linfático cervical pode ser observada nos pacientes com pescoço clinicamente negativo e que são submetidos ao esvaziamento cervical.…”

“…Apesar de pouco freqüente foram achados linfonodos metástaticos no nível V, fatos estes equivalentes aos da literatura 10,11,17 . Ao correlacionarmos a presença de metástase para o pescoço e o fato da lesão primária ultrapassar ou não a linha média,observamos que na análise estatística não houve associação significante entre a presença de linfonodos metástatico regionais e o fato da lesão primária invadir a linha media da base de língua.…”