Frequency of Occult Metastasis in Cevical Lymph Nodes in Patients with Squamous Cell Carcinoma of Oral Cavity

Objective: To determine the frequency of occult metastases in cervical lymph nodes in patients with squamous cell carcinoma (SCC) of oral cavity presenting at government tertiary care facilities of Karachi and Peshawar. Patients and Methods: This cross-sectional descriptive study was carried out at Department of Ear, Nose, Throat (ENT) and Head and Neck Surgery Lady Reading Hospital Peshawar and Jinnah Postgraduate Medical Centre, Karachi from June 2009 to February 2011. Fifty six patients were included who fulfilled the inclusion criteria after taking the informed consent. Results: A total of 56 punch biopsy proven cases of squamous cell carcinoma of all the sub sites of oral cavity with all T-stages were included in this study. The average age of the patients was 47.7±13.06 years (95% CI: 44.2 to 51.19) and minimum age of the patients was 22 years and maximum age was 75 years. Out of 56 patients, 37 (66.1%) were male and 19 (33.9%) were female. There are two hospitals from where patients were included and 80.36% patients were in Jinnah Postgraduate Medical Centre Karachi and 19.64% patients were from Lady Reading Hospital Peshawar. Regarding site of tumor, buccal mucosa was observed in 39 (69.64%) and tumor in tongue was found in 13 (23.21%).cases. Similarly tumour in floor of mouth, lower alveolus and retromolar trigone was also found in patients. Rate of tumor stages T2 and T3 was found in 23 (41.1%) each, rate of tumor stage T1 was eight (14.3%) and stage T4 was two (3.6%). Overall occult metastases rate was 33.9% (19/56). Rate of occult metastases was above 60% in less than 42 years of age while in between 54 to 64 years of age rate of occult metastases was 38.5% and above 64 years of age, it was observed in 16.7% cases. Similarly rate of occult metastases in males was 35.1% and in females was 31.6%. Conclusion: there is high incidence of occult metastasis with sqaumous cell carcinoma of oral cavity ant at least supraomohyoid neck dissection should be considered in cancers arising from oral cavity.

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