Neck node status in squamous cell carcinoma of the lower alveolus

Squamous cell carcinoma (SCC) is the most common malignant neoplasm of the oral cavity. According to literature, SCC of the lower alveolus account for 7.5 to 17.5% of all the oral cancers. Carcinoma of the lower alveolus is treated mainly by surgery followed by adjuvant therapy, depending upon the stage and histopathological characteristics. The purpose of this study was to evaluate the neck node status, distribution of patients according to T stage and management of squamous cell carcinoma of the lower alveolus. Methodology: 31 histopathologically proven cases of squamous cell carcinoma of the lower alveolus were included in present study. Recurrent cases and prior treatment of lower alveolus cancer by chemotherapy and radiotherapy were excluded. All the patients involved in the study underwent tumor resection with neck dissection. Results: A total of 31 patients were staged as per TNM criteria (AJCC 8th edition). 54.84% patients were pathologically node-negative (pN0). In pathologically node-positive (pN+) patients N3 category was the highest followed by N2 category and N1 category. T3 lesion was absent in this study. The lymph node positivity was maximum in T1 followed by T4. The percentage of T1, T2 and T4 lesions were 03.23, 06.46 and 90.32% respectively. Final histopathological stage grouping revealed early stage (stage I and II) disease in 2 patients and advanced stage (stage III and IV) disease in 29 patients. 02, 19 and 10 patients were treated by surgery alone, surgery with postoperative radiotherapy and surgery with postoperative CTRT respectively. Conclusion: This study concluded that majority (93.55%) of the patients had diagnosed in advanced stage of carcinoma. 45.16% of the patients were pathologically node-positive (pN+) and nearly one-third of the patients were pathologically node-positive with extranodal extension (pN+/ENE+). Histopathology reports demonstrated the most of the patients had well-differentiated squamous cell carcinoma. Stage I and II (Early stage) patients were treated primarily by surgery alone and stage III and IV (advanced stage) patients were treated with combination therapy.