The significance of false-positive nodes in patients with oral cancer

The significance of palpable non-metastatic (false-positive) lymph nodes in the neck of patients with head and neck cancer is not quite clear. These nodes may be the result of inflammation, which usually accompanies the primary tumor, or they may reflect an immunological response of the patient to the tumor. The present study was undertaken to elucidate this problem by comparing the survival rate of patients with false-positive necks to the rates of patients with true-negative, false-negative, or true-positive necks. The records of 138 patients with primary squamous cell carcinoma of the oral cavity who were treated surgically between 1980 and 1987 at the University of Toronto were reviewed. There were 53 patients with true-negative necks, 18 with false-negative necks, 35 false-positive necks, and the remaining 32 patients had true-positive necks. T-stage was the single variable with a significant impact on survival. Nodal status did not influence survival in patients with large primary tumors. In patients with T1 or T2 cancers, occult nodes did not, but palpable nodes did have a detrimental impact on survival. The presence of false-positive nodes did not have a beneficial effect on survival in this study. Possible explanations for this observation are discussed.