Frequency of bilateral cervical metastases in oropharyngeal squamous cell carcinoma: A retrospective analysis of 352 cases after bilateral neck dissection

Abstract

Bilateral neck dissection should be recommended for all but T1 and selected cases of T2 carcinomas of the tonsillar fossa.

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma

“…Researchers [7][8]33] have suggested that patients with primary tumor of the floor of the mouth, which is known to have a rich and bilateral lymphatic drainage pattern exhibit a higher risk of contralateral metastases than those with tongue tumors or those invading the retromolar trigone. It was also found that a higher rate of contralateral metastases in the base of the tongue, even in early tumors, than in tumors of the tonsillar fossa or the body and the tip of the tongue by Olzowy et al [21] and Califano et al [34]. However, diverse findings have also been reported the most-contrasting data showing a higher incidence of CLNM in cases of lower gum carcinoma (25%) in comparison with those tumors starting on the mobile tongue (15.4%) [13].…”

“…Other authors [13,21] have further demonstrated that patients with multiple ipsilateral positive nodes (two or more) presented with a higher risk for contralateral metastases or bilateral metastases than those with a single positive node or negative nodes.…”

“…In a retrospective analysis of 66 patients with cancer of the oral cavity at N0-2 stage, Koo et al [29] showed that the rate of contralateral occult metastasis was 8% for T2, 25% for T3, and 18% for T4, whereas no metastasis was observed in the T1 cases. It is also noteworthy that fewer bilateral metastases were seen for T1 tumors compared with more advanced primaries [21] and the patients with bilateral metastases had at least T2 disease or greater [39].…”

“…Some authors recognize that contralateral metastases of head and neck carcinomas can occur in different ways: firstly, by crossing afferent lymph vessels; and second by tumor spreading over the midline to reach efferent collateral lymphatic vessels while ipsilateral lymph nodes are extensively involved, where there is not a real midline barrier in certain anatomic areas [7]. The incidence of CLNM differs considerably among institutions from 0.9% to 36% [6,[8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

“…Several studies have widely described a correlation between large size at presentation and contralateral metastases, which are associated with an increased risk of poor survival [8,13,21,29,[35][36][37][38][39]. Risks of CLNM for cases of tumors at stage T4 and patients seen with two involved sites are significantly higher in relation to those with tumors confined to the original site or at early stage.…”