| dc.description.abstracteng | The lymph node status is a decisive prognostic factor in squamous cell carcinoma of the head and neck and has a decisive influence on the 5-year survival rate of the patient. The present study on 313 patients with oral cavity, oropharyngeal, hypopharyngeal and laryngeal carcinoma was intended to answer the question of the extent to which a more selective tumor surgical approach for head and neck cancer can be further established for therapeutic success. The study included 313 patients with cancers of the floor of the mouth, oropharynx, larynx and hypopharynx. All patients had a positive neck lymph node finding during neck dissection or there was a relapse. Based on these parameters, the results were recorded and evaluated retrospectively.The study showed an increased metastasis rate of all tumor regions with a share of 56%, especially in level II. In level III, 31% of the cervical metastases were detected, in level IV 6% of the metastases. In level I, 5% of the metastases could be detected. Of 313 patients, 132 (42%) patients developed a relapse. In 42% of the patients with a primary tumor of size pT3, a recurrence was diagnosed in the course of their tumor disease. In addition, it is also clear that the tumors that exhibited a regional lymph node metastasis with a capsular rupture had an increased tendency to recur. A locoregional relapse developed in 27 (52%) of 51 patients whose tumor showed metastasis across the capsule. There are indications that the tumor size has an influence on the development of recurrences. In the present study material, a relapse was diagnosed in 13% of the patients with a tumor of the category pT1, 31% had a tumor of the category pT2 and 42% a tumor of the category pT3. The recurrence rate in patients with a tumor of the pT4 category was only 14%.The results of the present study are in line with previous studies and showed similar results with regard to epidemiological data. With regard to the gender distribution, it was shown, comparable to other authors, that men (85%) more often developed head and neck tumors than women, who made up 15% of the patient population. In view of the results, an advanced tumor size is also strongly associated with the formation of lymph node metastases in the present patient collective. It was shown that the tumor stage, the lymphogenic metastasis pattern and growth across the capsule are essential prognostic factors and promote the development of recurrences. In order to be able to provide precise information on both the metastasis process and the occurrence of locoregional recurrences, an exact description of the removed neck dissection on the part of the surgeon is necessary. It makes sense to identify the lymph node groups removed individually according to the side of the neck and level and to name the total number of lymph nodes removed. | de |