Failure in Oral or Oropharyngeal Cancer with Single-Node Metastasis

Abstract

Objective: 1) Analyze the oncologic results and related clinicopathologic factors of patients with oral and oropharyngeal squamous cell carcinoma (OOSCC) who presented as clinically single lymph node metastasis, nd underwent surgery. 2) To find out a rationale for optimal management in these selected cases.

Method: Study design: Retrospective. Year study conducted: 10 years. Disease studied: Oral or oral cavity carcinoma with clinically single lymph node metastasis. Subjects: 54 patients. Setting: Tertiary center. Outcome measurement: Patterns of treatment failure, related clinicopathologic factors.

Results: There was no metastasis in level V as clinical presentation, and only 1 case showed occult metastasis. Among the 15 cases (28%) of treatment failure, recurrence of lymph node metastasis was identified in only 1 case (1.9%). The most common cause of treatment failure or death was distant metastasis, which occurred in 10 patients (18.5%). Clinical (P = .005) and pathologic (P = .003) T stage were risk factors for the distant metastasis.

Conclusion: Nodal recurrence was rare, and distant metastasis was the main cause of failure and death with OOPSCC with single lymph node metastasis. While there is feasibility to save level V in these cases, distant metastasis should be considered in adjuvant therapy and follow up for patients with advanced T stage.