CLINICAL STUDY ON TONGUE SQUAMOUS CELL CACINOMA AND CERVICAL LYMPH NODE METASTASIS

Objective:To investigate the patterns of cervical lymph node metastases from tongue squamous cell cacinoma and investigate the clinical value of the surgery for the toumor located lymphatic metastasis.Methods:A retrospective review of medical chart from 1980 to 1997 was performed.Ninety-six tongue squamous cell cacinoma patients who performed RND were included.The distribution of metastatic neck lymph node was analyzed.Results:Positive lymph node was found in 52.1% RNDs.Histological lymph node metastasis to level Ⅳ and Ⅴ was found in 3.3% of patients with N 0,5.0% with N 1,30.0% with N 2 and 31.3% with N 3.Histological lymph node metastasis to level Ⅳ and Ⅴwas found in 4.2% of patients without level Ⅲ lymph node metastasis and 57.7% of patients with level Ⅲ lymph node metastasis.Conclusion:Supraomo hyoid Neck Dissection was recommended to treat tongue squamous cell cacinoma of N 0 and N 1.N 2 and N 3 should be treated with RND including level Ⅰ-Ⅴ lymph nodes.After supraomohyoid neck dissection,frozen section of the level Ⅲ lymph node should be performed.If the result of the frozen section is positive,level Ⅳ and Ⅴ dissection should be performed.