The fixed cervical lymph node.

A series of almost 2000 patients with squamous carcinoma of the head and neck is presented. Seven percent of the patients had massive fixed glands at the time of presentation. The incidence of fixed nodes varied between sites, and increased with increasing T-stage of the primary tumor. Forty percent of the patients were treated; the most common cause for withholding treatment was advanced age. Radiotherapy did not produce a significant prolongation of survival, but surgery did. Resection of the mandible, the skin of the neck, and the external carotid artery proved to be valuable procedures both in terms of palliation and survival; radical surgery produced a 5-year survival of approximately 15%.