Introduction: Elective neck dissections are procedures to identifiy occult neck node metastases in head and neck cancer. Study design: Clinical retrospective. Aim: Evaluate occult metastasis in neck nodes in patients with head and neck squamous cell carcinoma. Material and Method: From 1977 to 1996, 428 patients submitted to elective neck dissection were evaluated, concerning the incidence of false negatives neck nodes (pN+), and its relation to the size (stage T), anatomic location, histologic graduation, sex, age and main lymphatic chains affected. Results: Occult metastasis were diagnosed in 32%, being 26% for larynx, 31% for orophaynx, 36% for oral cavity and 40% for hipopharynx. The level I and IV were predominant, and the level I only for the oral cavity. Between patients with occult metastasis, 56% presented multiples chains with metastasis. The stage I were related only with larynx tumors. Conclusions: The lymphatcs levels II and III were predominant for pharynx and larynx and the level I for the oral cavity. The others risk factors (age, gender and hystologic degree differenciation) were not responsible for occult metastases.
occult metastasis; squamous cell carcinoma; neck dissection; risk factors
