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

Overview

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

Key words:
nodal metastasis –primary tumour –diagnosis of metastases –treatment ofmetastases –survival of patients