The pattern of lymph node metastases in intra-oral squamous cell carcinoma.

Histological study of all radical neck dissection specimens from 98 patients with clinically operable intra-oral squamous cell carcinoma has been carried out since 1973 to establish not only the presence of positive nodes but their site in the neck. All cases treated primarily by other methods such as radiotherapy or chemotherapy were excluded. Positive lymph nodes, found in 73 specimens, were grouped according to the site of the primary lesion. In no patient were nodal metastases found in the posterior triangle or in the submental region. No tumour deposits were found in the salivary glands nor were any found either in or superficial to the sternomastoid muscle. Obviously several factors must be taken into account in deciding the place of "functional" as distinct from radical neck dissection in the treatment of intra-oral malignancy, but the findings in this survey provide evidence in favour of the simpler less radical approach.