Publication:

Clinical assessment of cervical node in head and neck malignancy: case series

Background Lymph node involvement is well established as an important prognostic factor for head and neck cancer, the spread of carcinoma of head and malignancy to the node levels is probably predictable according to the site of the primary. The appropriate staging of cervical lymph nodes is very important in the management of any head and neck primary carcinoma. Clinical palpation of cervical lymph nodes may yield false negative and false positive results.

Methods In a prospective study in patients of patients with primary malignancy from larynx, any sub site of pharynx (nasopharynx/oropharynx/hypopharynx) of histologically proven squamous cell carcinoma, the nodal status of primary tumour, the level of lymph node involved and the stage of presentation of the tumor and node were analysed clinically.

Results 61 cases included in our study, where males were 52 cases and females were 9 cases. The age incidence ranging from 35 years to 76 years noted. In the distribution of nodal secondary carcinoma of the nasopharynx was 100% nodal positive followed by hypopharynx, oropharynx, and larynx. 21% of patient presented in the N0 stage. The remaining 79% were node positive. In nodal secondary by size of primary most of the patients presented with T3 disease (52%) followed by T2 disease (26%), T1 disease (11%) and T4 disease (11%).

Conclusions In malignancy of larynx, pharynx, lymph node assessment clinically is an important prognostic factor to determine the staging of tumour. The clinical evaluation may also have false negative, so radiological evaluation will further give a detailed assessment of the nodes for better treatment outcomes to reduce the overall mortality.