title: Prognostic significance of the distribution of neck node metastasis from oral carcinoma.
abstract: BACKGROUND
  Carcinoma of the oral cavity presents a high risk for neck metastasis, which reduces the probability of regional control and survival.
  
  
  OBJECTIVE
  The main objective of this study is to analyze prognostic implications of the distribution of neck metastasis in 513 patients with squamous cell carcinoma of the oral cavity.
  
  
  METHODS
  All patients underwent surgery from 1970-1992. Tumor stages were I, 63; II, 120; III, 173; and IV, 157. Neck dissections were performed in 448 patients (115 bilateral).
  
  
  RESULTS
  By use of multivariate regression techniques the level of lymph node involvement was the most important prognostic factor (relative risks from 1.8 to 2.5). The following variables were also associated with prognosis: mobility of lymph nodes, sex, T stage, age, and tumor thickness.
  
  
  CONCLUSIONS
  The level of ipsilateral lymph node involvement was the most significant prognostic factor patients with in oral cancer who underwent surgical treatment. A significant decrease in survival also was seen with regard to the involvement of multiple contralateral lymph nodes. Our results support the indication of elective neck dissections in high-risk patients because among the cases that had metastases at follow-up, 50% were not candidates for salvage treatment.
authors.affiliation: Head and Neck Surgery Department, Hospital A. C. Camargo, Fundação Antonio Prudente, 211, 01509-010, São Paulo, Brazil.
authors.forename: L P
authors.initials: LP
authors.lastname: Kowalski
authors.forename: R
authors.initials: R
authors.lastname: Bagietto
authors.forename: J R
authors.initials: JR
authors.lastname: Lara
authors.forename: R L
authors.initials: RL
authors.lastname: Santos
authors.forename: J F
authors.initials: JF
authors.lastname: Silva
authors.forename: J
authors.initials: J
authors.lastname: Magrin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D015999:Multivariate Analysis; D009333:Neck; D009367:Neoplasm Staging; D010166:Palliative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D016019:Survival Analysis