EVOLUTION OF THE CLINICALLY NEGATIVE NECK IN PATIENTS WITH SQUAMOUS CELL CARCINOMA OF THE FAUCIAL ARCH

A review of 170 patients with squamous cell carcinoma arising in the faucial arch without evidence of lymph node metastasis on admission leads to the following conclusions:

1. Eight of 143 patients (5.6 per cent) who did not receive complete elective treatment to the entire neck at any time and whose primary cancer remained controlled died with cervical lymph node metastasis.

2. The 5.6 per cent of the patients cannot be identified by the size of the primary lesion or by the degree of undifferentiation of the primary lesion.

3. As one would expect, the incidence of contralateral lymph node metastasis is not influenced by treating the ipsilateral lower neck.

4. The frequency of distant metastasis is not increased when the ipsilateral neck is not electively treated.

5. The sequelae of treating 94.4 per cent of the patients does not justify the potential salvage of the 5.6 per cent who might have been benefited by complete elective treatment of the ipsilateral neck.

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