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CC BY-NC-ND 4.0 · South Asian J Cancer 2022; 11(04): 326-331
DOI: 10.1055/s-0041-1733348
Original Article
Head and Neck Cancer

Patterns of Neck Nodal Metastasis from Oral Cavity Carcinoma

Nitin Khunteta 
1   Department of Surgical Oncology, Sri Ram Cancer Centre, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
,
Ayush Makkar
1   Department of Surgical Oncology, Sri Ram Cancer Centre, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
,
Jaspreet Singh Badwal 
1   Department of Surgical Oncology, Sri Ram Cancer Centre, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
,
Prakhar Katta
1   Department of Surgical Oncology, Sri Ram Cancer Centre, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
,
Dinesh Choudhary
1   Department of Surgical Oncology, Sri Ram Cancer Centre, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
,
Mohinder Viswanath
1   Department of Surgical Oncology, Sri Ram Cancer Centre, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
,
Hemant Malhotra
2   Department of Medical Oncology, Sri Ram Cancer Centre, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
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Abstract

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Nitin Khunteta

Objectives The aim is to study the patterns of lymph node metastasis from various sites in oral cavity cancer and determine the risk factors for metastasis.

Materials and Methods It is a prospective observational study. The inclusion criteria were—245 patients of carcinoma buccal mucosa, anterior two-thirds of tongue, hard palate, oral surface of soft palate, floor of mouth, vestibule, and alveolus. The exclusion criteria were—patients who had received preoperative chemotherapy or radiotherapy and patients with recurrent disease.

Statistical Methods All data were analyzed using SPSS 18.0 and Graphpad prism 7 software for statistical analysis. Count data have been expressed as percentages (%). The χ 2 test was used for univariate analysis of the risk factors of cervical lymph node metastasis. The odds ratio value (with 95% confidence interval) was used to express the risk of cervical lymph node metastasis. p-Value of <0.05 was considered as the difference with statistical significance.

Results The most common site involved was buccal mucosa. Patterned lymph node metastasis was seen in 93.5% cases. Skip metastasis was seen in 4.31% cases. Level I b was the most common site of nodal involvement for all primary subsites of oral cavity cancer. The incidence of positive nodes on histopathological analysis was highest in cases of lower alveolus (63.15%), followed by tongue.

Conclusion In our study, patterns of lymph node metastasis for oral cavity cancer were comparable to other studies with large number of subjects. The incidence of skip metastasis or aberrant status was low. On multivariate analysis, depth of invasion of tumor, pathologic grade, pathologic T stage, and morphologic type of growth were found to be independent predictors of risk for metastasis.

Keywords

patterns of lymph node metastasis - oral cavity cancer - risk factors for metastasis - regional lymph node - skip metastasis - cervical lymph node

Authors' Contributions

N.K. and A.M. participated in the conception and design of the manuscript, drafting of manuscript, and literature search.


J.S.B., P.K., D.C., M.V., and H.M. participated in the drafting of manuscript and literature search.




Publication History

Article published online:
06 February 2023

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