Cervical nodal metastases in squamous cell carcinoma of the head and neck: What to expect

Abstract

The treatment and management of malignancies of the head and neck is directly altered by the presence of metastatic cervical adenopathy. The treatment of nodal metastases in squamous cell carcinoma of the head and neck (HNSCCA) is determined by the lymphatic drainage of the upper aerodigestive tract. The lymphatic drainage is site-specific and occurs in a predictable manner. The purpose of this text is to provide an overview of the normal routes of lymphatic drainage in the head and neck and correlate this with the current nodal classification system. The specific aims of this manuscript are to 1) illustrate the expected lymphatic drainage patterns of HNSCCA arising in the different subsites (nasopharynx, oropharynx, oral cavity, larynx, and hypopharynx) and 2) review the expected frequency of metastases within nodal groups for HNSCCA that arise in these locations. An understanding of the topographical distribution and incidence of cervical lymph node metastases plays an integral role in the physical examination and radiological evaluation of patients with HNSCCA. For the neuroradiologist, this information may increases the ability to identify those nodal groups at risk for metastatic involvement.

Primary tumor thickness as a risk factor for contralateral cervical metastases in T1/T2 oral tongue squamous cell carcinoma

“…This corresponds to the findings of Mukherji and others who found that oral tongue and floor-of-mouth cancers have an expected drainage to contralateral nodal basins in up to 9% of cases. 13 The site of oral tongue cancers may play a factor in the risk of contralateral metastases since the lymphatic drainage may differ in different areas of the oral tongue, but the numbers in the current study are too small to draw conclusions. The work of Mukherji and others also suggests that tongue and floor-of-mouth tumors have a similar risk of contralateral nodal involvement.…”

Manejo del cáncer de cabeza y cuello: ¿Radioterapia a quién, cuándo y por qué?

“…En una revisión de los principales trabajos publicados al respecto, se obtuvo el patrón de diseminación y la frecuencia de compromiso metastásico cervical subclínico según el sitio primario de 428 pacientes sometidos a disección cervical electiva (N0) 10 . Los resultados se resumen en la Tabla 3.…”

Factors associated with nodal metastasis in nasopharyngeal cancer: an approach to reduce the radiation field in selected patients

“…Therefore, it is reasonable to attempt to decrease the probability of carotid artery stenosis and other adverse effects by IMRT with a reduced CTV, if possible [20]. Lymphatic drainage of carcinomas of the head and neck has been associated with the primary tumour location and adjacent subsites to which the tumour has spread [21]. In the case of NPC, the lymphatic vessels of the nasopharynx drain in two general directions, lateral and medial [22].…”