title: Skin involvement and ipsilateral nodal metastasis as a predictor of contralateral nodal metastasis in buccal mucosa cancers.
abstract: BACKGROUND
  In view of low incidence of contralateral nodal metastasis and increase in the morbidity, the opposite neck is not routinely addressed. However, contralateral nodal metastasis is seen frequently in a certain group of patients. Identifying those factors associated with higher chances of contralateral nodal metastasis may help in optimizing the treatment.
  
  
  OBJECTIVE
  The aim of this study was to identify prognostic factors associated with contralateral nodal metastasis in cases of buccal mucosa cancers.
  
  
  METHODS
  A retrospective audit of 125 patients with squamous cell carcinoma of buccal mucosa at a tertiary cancer center.
  
  
  METHODS
  Those cases in which lesions were reaching or crossing midline were included in this study. All cases underwent surgery as primary modality of treatment and had bilateral neck dissection.
  
  
  METHODS
  Chi-square test is used for evaluating the variables predicting contralateral nodal metastasis. Finally, a multivariate analysis was performed using binomial logistic regression to identify those variables that were independently associated with the risk of contralateral nodal metastasis.
  
  
  RESULTS
  Among 125 patients, 53 cases were node negative. Ipsilateral nodal metastasis was seen in 44/125 (35.2%) patients, 26/125 (20.8%) had bilateral neck node metastasis, and 2/125 (1.6%) had isolated contralateral nodal metastasis. Among these 28 patients with contralateral nodal metastasis, 26 patients had ipsilateral nodal metastasis. Ipsilateral nodal metastasis and skin involvement were independently predictive of contralateral nodal metastasis.
  
  
  CONCLUSIONS
  Contralateral nodal metastasis in the absence of ipsilateral nodal metastasis is very rare and frozen section of ipsilateral neck dissection specimen can be an important pointer for addressing contralateral neck.
authors.affiliation: Department of Head and Neck Services, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: M
authors.initials: M
authors.lastname: Mair
authors.affiliation: Department of Head and Neck Services, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: S
authors.initials: S
authors.lastname: Nair
authors.affiliation: Department of Head and Neck Services, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Thiagarajan
authors.affiliation: Department of Head and Neck Services, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: J
authors.initials: J
authors.lastname: Agrawal
authors.affiliation: Department of Head and Neck Services, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: D
authors.initials: D
authors.lastname: Nair
authors.affiliation: Department of Head and Neck Services, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: P
authors.initials: P
authors.lastname: Chaturvedi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000473:pathology*; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*