The prognostic significance of metastatic cervical lymph nodes.

The ability to predict accurately the clinical course of a patient with a malignancy is critically important to the patient's subsequent management. It has been well documented that the presence of metastatic nodal disease is associated with decreased patient survival. Survival data from a group of 242 head and neck cancer patients from the University of Iowa were analyzed to determine the significance of specific characteristics of metastatic lymph nodes. Evaluation of absolute numbers and percentages of positive nodes or node size generally was not useful. However, involvement of the posterior triangle nodes, noncontiguous nodal sites, or multiple sites was associated with a worse prognosis. When that was accurate enough to be of help to the clinician in prognostication. The single most important feature seems to be documentation of the presence of metastatic nodal disease, rather than particular features (i.e., number, size) of the metastatic nodes.