Čes. stomatol. Prakt. zub. lék. (Czech Dental Journal) 2002; 102(3): 91-98

On the Problem of Nodal Metastases of Carcinomas in the Headand Neck Region

A. Brázda, V. Zbořil

Klinika ústní, čelistní a obličejové chirurgie FN a LF, Olomouc, přednosta prof. MUDr. J. Pazdera, CSc.

Squamous cell carcinomas of the head and neck area metastatize by the lymphatic route into locoregional lymph nodes. This typical property leads to a great variability of diagnosis and treatment. The authors analyze a group of 1379 patients treated on account of a malignant tumour in 1974-2000 from the aspect of basic epidemiological data on the prevalence of metastases in lymph nodes. They evaluate the relationhip of primary tumours and nodal metastases, and draw attention to the great differences between preoperative and postoperative classification. They present therapeutic possibilities and results of patientsurvival. The results of obervations confirm not only generally valid experience but also the fact that intraoral carcinomas metastatize 4 × more frequently into lymph nodes than extraoral carcinomals. Preoperative clinical diagnosis of lymph nodes is 3-4 × stricter than postoperative histopathological diagnosis. From the therapeutic aspect it was found that eradication of a primary tumour is more successful than cure of nodal metastases. In almost 50% of radical surgery supported by radiotherapy and possibly chemotherapy is not sufficient to arrest radically nodal progression. The authors found that diagnosis and therapy of tumourous metastases remains a basic problem and is at the same time a challenge to seek new solutions.

Keywords: nodal metastasis; primary tumour; diagnosis of metastases; treatment of metastases; survival of patients

Published: September 1, 2002  Show citation