[The surgical treatment of laterocervical adenopathies due to malignant cervicofacial tumors]

Head and neck malignant tumors show a high tendency to spread to cervical lymph nodes. Therefore, surgical approach to these neoplasms is primary tumor exeresis associated with functional or radical neck dissection, unilaterally or bilaterally at the same time, in relation to T site and N stage. In this paper the validity of such approaches is evaluated by correlating clinical and histopathologic N involvement in 168 patients with head and neck malignancies, observed in a 5-year period (1986-1990), and submitted to radical (65 pts.) and functional (198 pts.) neck dissection. The histopathologic findings showed 31 patients (14.7%) with N0+ (false negatives). The incidence of occult latero-cervical metastases confirms the importance of elective functional neck dissections in N0 patients with head and neck malignant tumors even though the risk of performing many unnecessary surgical procedures may be considerable (180 cases out of 211 in the Authors experience). Rare false positives (overall 4 cases) did not represent a significant clinical problem while N3 showed massive neoplastic invasion with extracapsular spread.