Perimarginal lymph nodes: an undervalued entity in oral cancer

Eur Arch Otorhinolaryngol. 2019 Apr;276(4):1147-1151. doi: 10.1007/s00405-019-05291-1. Epub 2019 Jan 18.

Abstract

Purpose: In a previous study, we gave a surgical description of a group of lymph nodes in the submandibular area at risk of remaining undissected during neck dissection (ND) for which we have proposed the term "perimarginal nodes" (PMNs) due to their proximity to marginal mandibular nerve (MMN). The aim of this study is to evaluate prevalence of PMNs involvement in oral cavity squamous cell cancer (OCSCC) and to verify if metastases are related to primary tumor characteristics or to the state of the neck.

Methods: We recruited a total of 39 consecutive patients diagnosed with OCSCC candidate to ND. Histological characteristics of PMNs were analyzed and the incidence of metastases in relation to the primary tumor characteristics were noted.

Results: PMNs were found to be involved with metastases in 8 patients (20.5%). No characteristic of the primary tumor seems to influence the metastatic involvement of the PMNs.

Conclusions: PMNs represent a frequent site of micro-metastases in patients diagnosed with OCSCC regardless of other characteristics of the primary tumor.

Keywords: Neck dissection; Oral cavity cancer; Perifacial nodes; Perimarginal nodes; Submandibular nodes.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Diagnostic Errors / prevention & control
  • Female
  • Humans
  • Incidence
  • Lymph Nodes* / diagnostic imaging
  • Lymph Nodes* / pathology
  • Lymph Nodes* / surgery
  • Lymphatic Metastasis* / pathology
  • Lymphatic Metastasis* / prevention & control
  • Male
  • Middle Aged
  • Mouth Neoplasms* / pathology
  • Mouth Neoplasms* / surgery
  • Neck
  • Neck Dissection* / adverse effects
  • Neck Dissection* / methods
  • Prognosis
  • Squamous Cell Carcinoma of Head and Neck* / pathology
  • Squamous Cell Carcinoma of Head and Neck* / surgery