title: Occult cervical metastases: immunoperoxidase analysis of the pathologically negative neck.
abstract: OBJECTIVE
  The purpose of this study is to better estimate the true incidence of occult regional metastases associated with stage I and II squamous cell carcinoma of the oral cavity. The clinical and prognostic significance of micrometastatic disease discovered by cytokeratin immunoperoxidase reactivity in the previously pathologically N0 neck is also evaluated.
  
  
  METHODS
  Forty patients treated between 1985 and 1996 with T1 or T2 squamous cell carcinoma of the lip and oral cavity were studied. All had primary surgical treatment including functional neck dissection. No metastases were demonstrated on hematoxylin and eosin microscopy. All specimens were reexamined with immunoperoxidase staining for cytokeratin.
  
  
  RESULTS
  Five percent of patients had micrometastatic disease. Retrospective analysis of patients with a minimum follow-up of 2 years has failed to show a statistically significant association between a positive cytokeratin analysis and poor locoregional control or overall survival.
  
  
  CONCLUSIONS
  Results suggest that the true incidence of occult metastases with carcinoma of the oral cavity is significantly higher than previously documented. However, the prognostic significance of these findings remains unclear.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: D J
authors.initials: DJ
authors.lastname: Enepekides
authors.forename: K
authors.initials: K
authors.lastname: Sultanem
authors.forename: C
authors.initials: C
authors.lastname: Nguyen
authors.forename: G
authors.initials: G
authors.lastname: Shenouda
authors.forename: M J
authors.initials: MJ
authors.lastname: Black
authors.forename: L
authors.initials: L
authors.lastname: Rochon
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality / Q000556:secondary*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality / Q000556:secondary*; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D015994:Incidence; D007633:Keratins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery; D037981:Neck Dissection; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D007633:Keratins