The determination of the presence or absence of metastases in the neck nodes is mandatory for cancer-bearing patients. Lesions classed as T1 may show a regional spread in 10 to 20% of cases, T2 lesions in 25 to 30% of cases and T3 to T4 tumours in 50 to 75%. The incidence of spread is influenced by the size of the tumour. However, its spreading to contralateral nodes is more common with midline and posterior lesions. Ipsilateral lymph nodes metastases are frequent. Oral cancer occurring in the posterior aspect of the oral cavity, oropharynx and inferior of the mouth tends to be associated with a higher incidence of spread to the lymph nodes at the time of diagnosis. In oral cancer, tumour dissemination occurs via regional lymphatic to cervical lymph node in a predictable and sequential fashion. Reports from the American Cancer Society indicate that, at the time of initial diagnosis, over 40% of patients with squamous cell carcinomas of the oral cavity and pharynx present with regional dissemination of the disease. Since squamous cell carcinoma constitutes the preponderance of primary malignancies of the head and neck, it is by far the most common tumour that spreads to the cervical nodes. It has a significant recurrence rate and frequently metastasizes to cervical lymph nodes. Oral squamous cell carcinoma is an invasive lesion with the presence of perineural growth.
Squamous cell carcinoma is the most frequent single entity, constituting 95% of all oral malignancies. Amongst those, oral cancer is the most common type of cancer. These represent about 6% of all cancer cases and account for a number of new cancer cases and cancer-related deaths worldwide every year. Head and neck cancer refers to epithelial malignancies of various parts of the orofacial region, which include paranasal sinuses, nasal cavity, pharynx and larynx, etc.
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