Cervical lymph node metastasis of squamous cell carcinoma of the oropharynx

Choi, Eun Chang; Koh, Yoon Woo; Kim, Chul Ho; Kim, Se Heon

Abstract

BACKGROUND AND OBJECTIVES
Squamous cell carcinoma of the oropharynx is a well known tumor with frequent nodal metastases, but reports on detailed prevalence of nodal metastasis by primary subunits and neck level are lacking.
Patients and Methods
To ascertain the prevalence of neck node metastasis by neck level, a retrospective review was undertaken of 63 previously untreated patients from 1992 to 2000, with primary squamous cell carcinoma of the oropharynx. All but one patients had undergone neck dissection; elective dissection in cN0 neck (n=19), and therapeutic dissection in cN+ neck (n=44).
RESULTS
Overall incidence of neck metastases was 76.2%. False negative and false positive rate were 31.6% and 4.5% respectively. More than 80% of patients with base of tongue and tonsillar carcinoma already had neck metastases at the time of treatment. Neck metastases was predominantly revealed in levels II, III, and IV. Metastases at level I and V was exclusively accompanied with metastases to other levels.
CONCLUSIONS
This study found that oropharyngeal squamous cell carcinoma frequently metastasized to the neck. Elective treatments are needed at the ipsilateral neck levels II, III, and IV, but comprehensive neck dissection for cases of the cN+ neck.