Correlation between prognosis and degree of lymph node involvement in carcinoma of the head and neck

The purpose of this report is to discover the correlation between the prognosis and the degree of lymph node involvement in carcinoma of the head and neck. Three hundred and thirty-eight cases of head and neck carcinoma who had undergone neck dissection at the National Cancer Center Hospital from 1962 through 1979 were reviewed and analyzed. The sites of the primary lesions were the oral cavity, larynx, and hypopharynx. Radical whole neck dissection had been performed in 177 cases, partial neck dissection in 97 cases, and bilateral neck dissection in 60 cases. The cervical lymph node metastases from oral cavity carcinoma were mostly confined to L1 and rare in L4 (L-classification by UICC). The prognosis of L4 cases was extremely poor, and thus oral carcinoma cases could be spared posterolateral dissection. The control rate of neck lymph nodes by neck dissection and the prognosis of the patients were influenced by the existence and number of histologically positive nodes. The cervical recurrence rates were 28% of all cases, 11% of histologically negative cases, and 39% of histologically positive cases. Recurrences in the dissected part of the neck were observed in 10% of all cases. The five-year survival rates were 75% of the cases without histologically positive nodes, 35% with histologically positive nodes, 59% with single node metastasis, and 26% with multiple node metastasis.