Treating Contralateral Neck in Recurrent Lesions of Ipsilateral Oral Squamous Cell Carcinoma-An Institute Experience

Neck node metastasis is an important factor determining overall survival in oral squamous cell carcinoma, while in the presence of contralateral lymph node metastasis in recurrent settings the prognosis is poorer. In recurrent ipsilateral disease, whether the opposite neck is to be addressed or not is still a controversy. Thus, the purpose of this study was to evaluate the incidence and factors predicting contralateral node metastasis. This is a monocentric retrospective study conducted at our institute over 3 years. A total of 634 patients were screened, out of which 48 patients underwent contralateral neck dissection for disease recurrence on the ipsilateral side. Various histopathological factors like depth of invasion (DOI), tumor stroma ratio (TSR), worst pattern of invasion (WPOI), grade, perineural invasion (PNI), and lympho-vascular invasion (LVI) were analyzed. The result of our study stated that the incidence of contralateral node metastasis for recurrent oral cavity tumors was 39.6%, and with a median DSS of 24 months, is 18 months for node-negative neck and 8 months for node-positive neck, whereas 5-year overall survival (OS) for node-positive is 3 years and 4.5 years for node-negative neck. Our study can make a pivotal change in decision-making and management of recurrent tumors, with the incidence of contralateral nodal metastasis at 39.6% and the presence of nodal metastasis significantly affecting disease-free and overall survival.