RESUMO
Introduction: Head and neck squamous cell carcinoma also carries a high rate of occult nodal metastasis. It is important todetect lymph node development in its early stages for improving the prognosis. The mechanisms by which malignant tumors,invade lymphatics, and metastasize to regional lymph nodes are complex and interrelated, the exact mechanisms have onlyrecently been the subject of intense interest and sophisticated experimentation.Aim: The aim of the study was to correlate the incidence of cervical node metastases by the site of primary in squamous cellcarcinoma of the head and neck region and to correlate individually the size of the tumor and its degree of histopathologicaldifferentiation.Materials and Methods: The present prospective study of 60 patients with proven squamous cell carcinoma at various sitesof head and neck was undertaken to study the possible tumor factors which influence the incidence and the pattern of regionalnodal metastases.Results: A progressive increase in the incidence of node metastases was observed with increasing tumor size 55.55%for lesions smaller than 2 cm, 75% for lesions between 2 and 4 cm, and 100% for lesions larger than 4 cm. A progressiveincrease in the incidence of node metastasis was observed with increasing histological undifferentiation of the tumor (4.3% forwell-differentiated primaries and 75% for moderately differentiated primaries).Conclusion: Large primaries (more than 4 cm) and those with higher histologic grade (moderate to poorly differentiated)especially when situated in the oropharynx or the oral tongue, have a greater propensity for developing regional nodal metastasiscompared to the rest.