title: Isolated perifacial lymph node metastasis in oral squamous cell carcinoma with clinically node-negative neck.
abstract: The incidence of occult perifacial nodal disease in oral cavity squamous cell carcinoma is not well reported. The purpose of this study was to evaluate the incidence of isolated perifacial lymph node metastasis in patients with oral squamous cell carcinoma with a clinically node-negative neck. The study will shed light on current controversies and will provide valuable clinical and pathological information in the practice of routine comprehensive removal of these lymph node pads in selective neck dissection in the node-negative neck.
  
  
  
  Prospective analysis.
  
  
  
  This study was started in August 2011 when intraoperatively we routinely separated the lymph node levels from the main specimen for evaluation of the metastatic rate to different lymph node levels in 231 patients of oral squamous cell cancer with a clinically node-negative neck.
  
  
  
  The current study demonstrated that 19 (8.22%) out of 231 patients showed ipsilateral isolated perifacial lymph node involvement. The incidence of isolated perifacial nodes did not differ significantly between the oral tongue (7.14%) and buccal mucosa (7.75%). Incidence was statistically significant in cases with lower age group (<45 years), advanced T stage, and higher depth of tumor invasion.
  
  
  
  Isolated perifacial node metastasis is high in oral squamous cell carcinoma with a clinically node-negative neck. The incidence of isolated perifacial involvement is high in cases of buccal mucosal and tongue cancers. A meticulous dissection of the perifacial nodes seems prudent when treating the neck in oral cavity squamous cell carcinoma.
  
  
  
  4 Laryngoscope, 126:2252-2256, 2016.
authors.affiliation: Department of Head and Neck Oncosurgery, Medanta Cancer Institute, Medanta-The Medicity, Gurgaon, India. drsangeetagarwal@gmail.com.
authors.forename: Sangeet Kumar
authors.initials: SK
authors.lastname: Agarwal
authors.affiliation: Department of Head and Neck Oncosurgery, Medanta Cancer Institute, Medanta-The Medicity, Gurgaon, India.
authors.forename: Sowrabh Kumar
authors.initials: SK
authors.lastname: Arora
authors.affiliation: Department of Head and Neck Oncosurgery, Medanta Cancer Institute, Medanta-The Medicity, Gurgaon, India.
authors.forename: Gopal
authors.initials: G
authors.lastname: Kumar
authors.affiliation: Department of Head and Neck Oncosurgery, Medanta Cancer Institute, Medanta-The Medicity, Gurgaon, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Sarin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary*; D005145:Face; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery; D009333:Neck; D037981:Neck Dissection / Q000379:methods*; D011446:Prospective Studies; D055815:Young Adult
keywords: Perifacial nodes; node-negative neck; oral squamous cell carcinoma; selective neck dissection