A study of neck secondaries in pharyngeal and laryngeal malignancies.

Lymphatic metastasis is the most important mechanism in the spread of head and neck malignancies. The rate of metastasis probably reflects the aggressiveness of the primary tumour and is an important prognosticator. Not only the presence, but also the number of nodal metastases, the level in the neck, the size of the nodes and the presence of extracapsular spread are important prognostic factors. Majority of the cervical metastases were due to squamous cell carcinoma of the head and neck. • Certain primary sites had a predilection for certain group of nodes. • Thus in this study, the incidence of cervical nodal metastasis is highest for: i. Nasopharyngeal tumours (100%) followed by ii. Hypopharyngeal tumours (87%) iii. Oropharyngeal tumours (83%) and iv. Laryngeal tumours (57%) • Lesions of nasopharynx metastasise to levels II and V. • Lesions of oropharynx metastasise to levels II, III and I. • Lesions of hypopharynx metastasise to II, III and IV and a small proportion to level VI. • Lesions of larynx metastasise to levels II and III and a small proportion to levels IV and VI. • Most of the patients presented with positive nodes belonged to N2 stage followed by patients in N1 stage. • Jugulodigastric nodes (level II) are involved more often than other groups or other levels of nodes. • In most of the cases, increasing size of the primary had increasing number of nodes as well as an increasing ‘N’ stage