Recurrence of carcinoma of the oral cavity, oropharynx and maxillary sinus after radical neck dissection.

Cervical recurrence was studied in 63 patients who had undergone radical neck dissection for the treatment of carcinoma of the oral cavity, oropharynx and maxillary sinus. Over the whole series, recurrence occurred in 17 patients (27%). The rate of recurrence did not decrease in patients who remained free of carcinoma at the primary site, but was significantly lower in patients in whom elective neck dissection was performed than in those who were treated by therapeutic or secondary neck dissection. With the exception of two patients, cervical recurrence was associated with the presence of metastatic lymph nodes. Although the rate of recurrence was not affected by the number of metastatic lymph nodes, it was very high (80%) in patients having metastatic lymph nodes with histological evidence of extra-nodal spread. The results indicate that elective treatment by irradiation or surgery may be needed to reduce cervical recurrence because of a high tendency of carcinoma of the oral cavity and adjacent regions to metastasize.