title: Detection of Cervical Lymph Node Micrometastases in Patients with Squamous Cell Carcinoma of the Oral Cavity, Pharynx and Larynx.
abstract: BACKGROUND
  The goal of this prospective study was to determine the frequency of micrometastases in patients with squamous cell carcinoma (SCC) of the oral cavity, pharynx and larynx in whom elective neck dissection was indicated (cN0).
  
  
  METHODS
  A total of 12 patients (10 males and 2 females) were enrolled in the study. The age ranged 42-73 years (median 62 years). Elective neck dissection was performed in all patients (8 ipsilateral, 4 bilateral) and a total of 256 lymph nodes were removed and sent for microscopic examination.
  
  
  RESULTS
  The presence of tumor cells in cervical lymph nodes was found in 5/12 (42%) patients. Micrometastases of SCC were found in two patients and isolated tumor cells (ITC) in two other patients. In the remaining one patient with oropharyngeal SCC, a micrometastasis of papillary thyroid carcinoma (PTC) was detected. Positive lymph nodes were localized in level II in three patients with SCC of larynx, hypopharynx and tongue base, respectively, in level I in one patient with SCC of oral tongue and in level III in one patient with PTC.
  
  
  CONCLUSIONS
  Our results indicate that SCC of head and neck has a high potential for creating micrometastases which frequency is higher compared to clinically detected macrometastases. Therefore, elective neck dissection or radiotherapy of the neck should be considered in patients with high risk of occult metastases or micrometastases.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Čelakovský
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic. david.kalfert@email.cz.
authors.forename: David
authors.initials: D
authors.lastname: Kalfeřt
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic.
authors.forename: Katarína
authors.initials: K
authors.lastname: Smatanová
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic.
authors.forename: Viktor
authors.initials: V
authors.lastname: Chrobok
authors.affiliation: The Fingerland Department of Pathology, University Hospital Hradec Králové, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Laco
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D018153:Czech Republic; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery; D037981:Neck Dissection / Q000379:methods*; D061206:Neoplasm Micrometastasis / Q000175:diagnosis / Q000473:pathology; D009367:Neoplasm Staging; D010347:Patient Care Planning; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results
keywords: Head and neck squamous cell carcinoma; Isolated tumor cells; Micrometastases; Occult metastases