THE SIGNIFICANCE OF FALSE-POSITIVE NODES IN PATIENTS WITH ORAL-CANCER

The significance of palpable non-metastatic (false-positive) lymph nod es in the neck of patients with head and neck cancer is not quite clea r. These nodes may be the result of inflammation, which usually accomp anies the primary tumor, or they may reflect an immunological response of the patient to the tumor. The present study was undertaken to eluc idate this problem by comparing the survival rate of patients with fal se-positive necks to the rates of patients with true-negative, false-n egative, or true-positive necks. The records of 138 patients with prim ary squamous cell carcinoma of the oral cavity who were treated surgic ally between 1980 and 1987 at the University of Toronto were reviewed. There were 53 patients with true-negative necks, 18 with false-negati ve necks, 35 false-positive necks, and the remaining 32 patients had t rue-positive necks. T-stage was the single variable with a significant impact on survival. Nodal status did not influence survival in patien ts with large primary tumors. In patients with TI or T2 cancers, occul t nodes did not, but palpable nodes did have a detrimental impact on s urvival. The presence of false-positive nodes did not have a beneficia l effect on survival in this study. Possible explanations for this obs ervation are discussed.