Evaluation the level of cervical Metastatic lymph node of the patients with oral squamous cell carcinoma

Background: Oral squamous cell carcinoma (OSCC) is the most common type of oral cancer that affects the head and neck region with highest mortality rate among all malignancies and it is the sixth common malignancy reported worldwide. Aims: To evaluate the level of cervical lymph node metastasis in patients with oral squamous cell carcinoma. Methods: This prospective study was done in Oral and Maxillofacial Surgery Department, Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period of July 2015 to June 2017. Fifty six patients with oral squamous cell carcinoma were included in this study. After the clinical evaluation, all patients were undergone to either unilateral or bilateral neck dissection. The excised lymph nodes along with fibrofatic tissue were examined histopathologically according to level base to find out the lymph node status. Result: Lymph node metastasis was significantly increased with the increases of tumour size in OSCC. Histopathologically this study showed, 57.1% cases had lymph node metastasis, where 53.1% patients had lymph node metastasis at level-I, 25.0% patient had metastasis at level-II, 15.6% patients had lymph node metastasis at both level-I and II and 6.3% patients had metastasis at both level-II and III. In this study no lymph node metastasis was found at level-IV and level-V. Conclusion: Selective supraomohyoid neck dissection (level I-III) should be done as an elective treatment in T1-T4. Lymph node Level IV should be included only when there is preoperative suspicion of level II or III nodal involvement.