Abstract
Patterns of tumour spread are examined in 160 patients with squamous carcinomas of the head and neck with reference to perineural infiltration, direct invasion of bone and ossified cartilage, and lymph node metastases in the previously irradiated neck. Perineural spread is comparatively common in large (T3, T4) tumours; it may be apparent early in the disease; it is often detectable clinically; and it is an adverse prognostic feature which may modify clinical management. Direct bone invasion is described with particular reference to tumours of the oral cavity. Most bone destruction is mediated by osteoclasts which appear to be stimulated by materials such as prostaglandins released in the vicinity of the tumour. The numbers of involved lymph nodes in surgical dissections from the irradiated neck are usually few and restricted to the submandibular and jugular groups; nodes in the posterior triangle are infrequently involved by metastatic carcinoma. Transcapsular spread and keratin granulomas are common. The scope of modified neck dissections in this group of patients is discussed.
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- BALLANTYNE A. J., MCCARTEN A. B., IBANEZ M. L. THE EXTENSION OF CANCER OF THE HEAD AND NECK THROUGH PERIPHERAL NERVES. Am J Surg. 1963 Oct;106:651–667. doi: 10.1016/0002-9610(63)90074-6. [DOI] [PubMed] [Google Scholar]
- BYARS L. T. Extent of manidbular resection required for treatment of oral cancer. AMA Arch Surg. 1955 Jun;70(6):914–922. doi: 10.1001/archsurg.1955.01270120122014. [DOI] [PubMed] [Google Scholar]
- Bennett A., Carter R. L., Stamford I. F., Tanner N. S. Prostaglandin-like material extracted from squamous carcinomas of the head and neck. Br J Cancer. 1980 Feb;41(2):204–208. doi: 10.1038/bjc.1980.31. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Carter R. L., Tanner N. S., Clifford P., Shaw H. J. Direct bone invasion in squamous carcinomas of the head and neck: pathological and clinical implications. Clin Otolaryngol Allied Sci. 1980 Apr;5(2):107–116. doi: 10.1111/j.1365-2273.1980.tb01636.x. [DOI] [PubMed] [Google Scholar]
- Carter R. L., Tanner N. S., Clifford P., Shaw H. J. Perineural spread in squamous cell carcinomas of the head and neck: a clinicopathological study. Clin Otolaryngol Allied Sci. 1979 Aug;4(4):271–281. doi: 10.1111/j.1365-2273.1979.tb01900.x. [DOI] [PubMed] [Google Scholar]
- Dodd G. D., Dolan P. A., Ballantyne A. J., Ibanez M. L., Chau P. The dissemination of tumors of the head and neck via the cranial nerves. Radiol Clin North Am. 1970 Dec;8(3):445–461. [PubMed] [Google Scholar]
- Galasko C. S. Mechanisms of bone destruction in the development of skeletal metastases. Nature. 1976 Oct 7;263(5577):507–508. doi: 10.1038/263507a0. [DOI] [PubMed] [Google Scholar]
- Galasko C. S. The pathological basis for skeletal scintigraphy. J Bone Joint Surg Br. 1975 Aug;57(3):353–359. [PubMed] [Google Scholar]
- Goldman J. L., Bloom B. S., Zak F. G., Friedman W. H., Gunsberg M. J., Silverstone S. M. Serial microscopic studies of radical neck dissections. Studies in a combined radiation and surgery program for advanced cancer of the larynx and laryngopharynx. Arch Otolaryngol. 1969 Apr;89(4):620–628. doi: 10.1001/archotol.1969.00770020622014. [DOI] [PubMed] [Google Scholar]
- Kalnins I. K., Leonard A. G., Sako K., Razack M. S., Shedd D. P. Correlation between prognosis and degree of lymph node involvement in carcinoma of the oral cavity. Am J Surg. 1977 Oct;134(4):450–454. doi: 10.1016/0002-9610(77)90376-2. [DOI] [PubMed] [Google Scholar]
- Lee E. S., Wilson J. S. Carcinoma involving the lower alveolus. An appraisal of past results and an account of current management. Br J Surg. 1973 Feb;60(2):85–107. doi: 10.1002/bjs.1800600202. [DOI] [PubMed] [Google Scholar]
- Lindberg R. Distribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer. 1972 Jun;29(6):1446–1449. doi: 10.1002/1097-0142(197206)29:6<1446::aid-cncr2820290604>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
- MARCHETTA F. C., SAKO K., BADILLO J. PERIOSTEAL LYMPHATICS OF THE MANDIBLE AND INTRAORAL CARCINOMA. Am J Surg. 1964 Oct;108:505–507. doi: 10.1016/0002-9610(64)90144-8. [DOI] [PubMed] [Google Scholar]
- Marchetta F. C., Sako K., Murphy J. B. The periosteum of the mandible and intraoral carcinoma. Am J Surg. 1971 Dec;122(6):711–713. doi: 10.1016/0002-9610(71)90432-6. [DOI] [PubMed] [Google Scholar]
- Zoller M., Goodman M. L., Cummings C. W. Guidelines for prognosis in head and neck cancer with nodal metastasis. Laryngoscope. 1978 Jan;88(1 Pt 1):135–140. doi: 10.1002/lary.1978.88.1.135. [DOI] [PubMed] [Google Scholar]








