Size of Cervical Lymph Node and Metastasis in Squamous Cell Carcinoma of the Oral Tongue and Floor of Mouth
Weerawut Jarungroongruangchai MD*, Mongkol Charoenpitakchai MD**, Tawatchai Silpeeyodom MD***, Chatchai Pruksapong MD*, Chairat Burusapat MD*
Affiliation : * Division of Plastic and Reconstructive surgery, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand ** Department of Pathology, Phramongkutklao college of Medicine, Bangkok, Thailand *** Department of Anatomical Pathology, Army Institute of Pathology, Bangkok, Thailand
Background : Squamous cell carcinoma (SCC) of the oral tongue and floor of mouth are the most common head and neck
cancers. Regional metastasis of SCC is most likely found at the cervical lymph node. Size and characteristics of pathologically
suspicious lymph nodes are related to the aggressiveness of the primary tumor. The objective of this study is to analyze the
correlation between sizes of cervical node and metastasis in SCC of oral tongue and floor of mouth.
Material and Method: Retrospective review was conducted from the patient’s charts between January 2008 and December
2012. Clinical, histopathology and surgical records were reviewed. Cervical lymph nodes of SCC of oral tongue and floor of
mouth were reviewed and divided into four groups depending on their size (1-5 mm, 6-9 mm, 10-30 mm and more than 30
mm). A p-value <0.05 was considered statistically significant.
Results : 196 patients with SCC of the oral cavity were recorded. Sixteen patients of SCC of the oral tongue and 15 patients of
SCC of the floor of mouth underwent neck dissection (641 cervical nodes). Most of the patients were diagnosed with stage 3
(41.94%). Extracapsular extension was found in 72.15% of SCC of oral tongue and 73.33 % of SCC of the floor of mouth. Size
of cervical lymph nodes less than 10 mm was found to be metastasis at 9.27% and 10.82% of SCC of oral tongue and floor
of mouth, respectively.
Conclusion : Cervical node metastasis can be found in SCC of the oral tongue and floor of mouth with clinically negative node
and size of cervical node less than 10 mm. Here in, size of cervical node less than 10 mm was still important due to the chance
for metastasis especially high grade tumors, advanced stage cancer and lymphovascular invasion.
Keywords : Squamous cell carcinoma, Oral tongue, Floor of mouth, Cervical lymph node
