Clinical and histological latero-cervical nodal metastases in squamous oropharyngeal carcinoma

The goal of our study was to estimate the presence (or absence) of latero-cervical nodal metastases (pN+), in patients with squamous oropharyngeal cancer, correlating this finding with T stage. We examined 255 patients out of 329 affected by squamous oropharyngeal cancer, from 1976 to 2005. The 255 patients examined were treated surgically (both T and N). As far as clinical latero-cervical nodal metastases were concerned, 215 patients (84%) were cN+, while 40% (16%) were cN-. The result of the histological examination showed that 82% of the neck dissections (both cN+ and cN-) actually had latero-cervical metastases, while the remaining patients had reactive lymph nodes. The false-positive (cN+ -->pN-) patients, were 14% while false-negative patients (cN- -->pN+) amounted to 63%. The correlation between T and pN+ of the patients classified as cN- showed that 24% of patients were T1, 44% T2, 32% T3, and none T4; the pN+ patients, who clinically manifested latero-cervical lymph-node metastases were: T1 8%, T2 15%, T3 37%, T4 40%. Analysis of these data led us to the conclusion that, in view of the high lymphophilia of squamous cancer in the oropharyngeal district, it would be advisable to treat N metastases, both cN+ and cN-, at any T stage of cancer, surgically or with chemo- or radiotherapy, according to the patient's performance status.