Prognostic significance of the distribution of neck node metastasis from oral carcinoma

Background. Carcinoma of the oral cavity presents a high risk for neck meta stasis, which reduces the probability of regional control and survival. Objectives. The main objective of this study is to analyze prognostic impli cations of the distribution of neck metastasis in 513 patients with squamou s cell carcinoma of the oral cavity. Patients and methods. All patients underwent surgery from 1970-1992. Tumor stages were I, 63; ii, 120, iii, 173; and IV, 157. Neck dissections were pe rformed in 448 patients (115 bilateral). Results. By use of multivariate regression techniques the level of lymph no de involvement was the most important prognostic factor (relative risks fro m 1.8 to 2.5). The following variables were also associated with prognosis: mobility of lymph nodes, sex, T stage, age, and tumor thickness. Conclusions. The level of ipsilateral lymph node involvement was the most s ignificant prognostic factor patients with in oral cancer who underwent sur gical treatment. A significant decrease in survival also was seen with rega rd to the involvement of multiple contralateral lymph nodes. Our results su pport the indication of elective neck dissections in high-risk patients bec ause among the cases that had metastases at follow-up, 50% were not candida tes for salvage treatment. (C) 2000 John Wiley & Sons, Inc.