Secondary neck nodes from squamous cell carcinoma: a study of 67 patients from Tamil Nadu

Background: In the present study, nine areas of the head and neck inclusive of five primary sites in the oral cavity and three in the oropharynx and the maxillary antrum were examined in the patients presenting with squamous cell carcinoma of the head and neck. Methods: 67 subjects with histologically proven squamous cell carcinoma with varying degrees of differentiation were included in the study. Results: It was found that 20% of the patients were in the age group of 31 to 40 years, 55% were in the age group of 41-50 years, 16.6% were in the age groups of 51 to 60 years and 8.3% were in the age group of 61 to 70 years. In patients with lesions smaller than 2 cm, 44.44% percent subjects had cervical node metastases; whereas in patients with lesion size between 2.1 to 4 cm, 75% had cervical node metastases. However, in subjects with lesion size above 4 cm, 100 % of the patients had cervical node metastases. Patients with large primaries of greater than 4 cm and those with higher histological grade ranging from moderate to poorly differentiated metastases showed a greater prevalence of nodal regional metastases compared to the rest. With decreasing degree of differentiation, an increased prevalence of nodal metastases was observed. Conclusions: This study suggests an early age of occurrence of squamous cell carcinoma in our population and increase in cervical nodal metastases with increasing tumor size and decrease in degree of differentiation.