Facial node involvement in head and neck cancer

Background. Facial node involvement in head and neck cancer is rarely documented. Furthermore, facial node removal may increase the risk of damage to the marginal mandibular nerve. Thus, although they may receive afferent lymphatic drainage from the oral cavity, facial nodes are rarely removed during neck dissection. Methods. We retrospectively reviewed the records of 29 patients with oral cavity or oropharyngeal carcinomas who underwent facial node sampling in 32 heminecks during neck dissection for oral cavity or oropharyngeal cancer. Results. Facial node metastases were present in seven patients. Facial node involvement was much more common among patients with palpable cervical lymphadenopathy. Positive facial nodes were associated with an increased risk of treatment failure and a poorer survival. Conclusions. In patients with oral cavity/oropharyngeal primary tumors and palpable cervical lymphadenopathy, consideration should be given to removal of facial nodes during neck dissection; however, further data are awaited before any benefits can be quantified.