Pattern of Cervical Lymphnode Metastasis from Oropharyngeal Squamous Cell Carcinoma

Abstract

Background: Oropharyngeal squamous cell carcinoma (OSCC) is the sixth most common malignancy globally, often presenting with cervical lymph node metastasis. Due to limited local data, this study aimed to assess the pattern of cervical lymph node metastasis in OSCC at the Department of Otolaryngology & Head-Neck Surgery, Sylhet M.A.G Osmani Medical College. Methods: This hospital-based cross-sectional study was conducted over 6 months with ethical approval. A total of 100 patients with OSCC were enrolled using predefined criteria. Data were collected via structured questionnaires, clinical evaluations, imaging (CT/MRI), FNAC, biopsy, histopathology, and operative findings, then analyzed using SPSS 26.  Results: The mean age was 53.09±9.35 years; 65% were male and 80% belonged to the lower-middle socioeconomic class. Lymph node involvement was ipsilateral in 75%, contralateral in 20%, and bilateral in 5%. Multiple nodal involvement was seen in 70%. Nodes were hard (52%), firm to hard (35%), and cystic (2%), with 70% being mobile. Node size exceeded 6 cm in 45% of cases. Primary tumor sites were tonsil (55%), base of tongue (25%), soft palate (15%), and posterior pharyngeal wall (5%). Tumor staging showed T2 (54%), T1 (24%), T3 (13%), and T4 (9%), while nodal stages were N3 (45%), N2 (35%), and N1 (20%). Ipsilateral nodal involvement was highest at level II (52%) and III (24%).  Conclusion: Tonsil was the most common primary site. Most metastases were ipsilateral, with level II and III lymph nodes most frequently involved. Further research is warranted for broader validation.