PROGNOSTIC FACTORS OF CERVICAL LYMPH-NODE METASTASIS IN HEAD AND NECKSQUAMOUS-CELL CARCINOMA

Aims and background: The metastatic spread of squamous cell carcinoma of the head and neck (SCCHN)! to the cervical lymph nodes is a negativ e prognostic factor In terms of survival. We have used multivariate an alysis to identify the possible prognostic significance of a number of clinical and pathological characteristics in relation to possible inv olvement of the cervical lymph nodes in a series of 396 patients. Meth od: 396 patients with SCCHN were studied. Variables regarding the pati ent, the carcinoma and histology were analysed by multivariate analysi s using BMDP's PLR programme. Results: Some variables appear to repres ent predisposing factors for tumor spread to the lymph nodes: tumor si te (supraglottic larynx: P=0.005; base of the tongue: P=0.02; hypophar ynx: P=0.02), grading (P=0.001), and a number of histological paramete rs (lower degree of histological differentiation: P=0.001; vascular pe rmeation: P=0.04; perineural invasion: P<0.05; prevalently plasmocytic infiltrate: P<0.05). Conclusion: The identification of cases at risk for metastasis can be improved by the assessment of prognostic factors , with a consequent improvement in treatment strategies.