Evaluation of the clinical and histopathological characteristics of the tumor as factors for the occurrence of metastases in the cervical lymph nodes in squamous cell carcinoma of the head and neck

Introduction: Squamous cell carcinomas in the maxillofacial region exhibit a significant predisposition for
metastasizing to the cervical lymph nodes, which constitutes a negative prognostic factor. In clinical practice, the
TNM classification is employed for treatment planning; however, it does not provide insights into the histological
characteristics of the tumor, which offer predictive information for subsequent treatment and prognosis.
Patients and methods: This study was conducted on 74 patients who underwent surgery in the Department of
Maxillofacial Surgery at the Clinical Hospital in Stip, during the period from February 2022 to March 2024. All
patients underwent resection of the primary tumor and appropriate neck dissection. The clinical assessment
included the location and size of the tumor, as well as nodal status. The histological evaluation encompassed
depth of invasion, degree of differentiation, lymphovascular and perineural invasion, and the stage of the disease.
Objective: The aim of this study is to present an evaluation of the clinical and histopathological features of the
tumor as factors influencing the occurrence of metastases in the cervical lymph nodes in cases of squamous cell
carcinoma of the head and neck.
Results: We identified a correlation between the clinical nodal stage and the assessed histopathological
characteristics of the tumor. Depth of invasion, poor pathological differentiation, and lymphovascular invasion
were considered risk factors for the development of cervical lymph node metastases and an unfavorable prognosis.
Conclusion: The evaluation of the histopathological features of the tumor should be the initial step in investigating
their role as significant predictors of the occurrence of neck metastases. The findings of this study may contribute
to the establishment of criteria for assessing the risk of metastasis and the prognosis of patients with HNSCC.
Keywords: cervical lymph nodes, prognostic factors, elective neck dissection, HNSCC