A retrospective study of ninety patients with early squamous cell carcinoma of the oral cavity was undertaken to evaluate clinical and histopathologic parameters in predicting cervical lymph node metastasis. Medical records were examined for age, sex, primary site, growth pattern and size. The specimens of biopsy and surgical excision were examined for degree of differentiation, mode of invasion, tumor thickness and muscular invasion.
The results were as follows;
1. Occult cervical nodal metastasis was 22.2 percent for patients with early squamous cell carcinoma. (18.2 percent in stage Ⅰ, 28.6 percent in stage Ⅱ)
2. The primary site, maximal surface diameter and histologic differentiation of tumor had no significant relationship with nodal metastasis.
3. Although maximal surface diameter showed little correlation with cervical nodal involvement, it is noteworthy that there were low incidence (7.7%) of cervical nodal metastasis in lesions with less than or equal to 10mm.
4. Clinical growth pattern was a important parameter relatively in predicting cervical nodal metastasis. Four (57.1%) of seven patients with indurative typed tumor had nodal metastasis.
5. Tongue carcinoma have a propensity to infiltrate the skeletal muscle than lesions at other oral sites, due to the difference of anatomical structure. Therefore, tongue carcinoma may related to a greater tendency of cervical nodal metastasis compared to the carcinoma of floor of the mouth.
6. Mode of invasion was important histopathologic parameter in assesing the ability to metastasized. Grade 4 had twice risk of cervical nodal metastasis than Grade 2 and 3. Tumors with papillary or indurative type and Grade 4 had a cervical
metastasis of sixty percent.
7. Tumor thickness showed an strong correlation with the appearance of later cevical nodal metastasis. The lesions less than or equal to 1.5mm had not evidence of cervical nodal metastasis. On the other hand, this incidence increased to 20.5, 37, 50% when the lesion was 1.6 to 3.0mm, 3.1 to 6.0mm, more than 6.0mm in thickness, respectively.
8. Tumors with Grade 4 and more than 3mm in the thickness, and with Grade 3 and more than 6mm in thickness had a cervical metastasis of fifty percent.
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