Hi to everyone,

I have a question--why are neck metastases to the lymph nodes "the single most important factor in determining prognosis"? (please google the text in quotes to find the source--this verbiage shows up in numerous articles).

I realize this is a question for my doctor, but I was hoping someone may have insight on this from experience.

My very simplistic understanding of anatomy is that lymph nodes catch the bad things and hold them until the posse comes--in the case of scca, the posse is overwhelmed, and the nodes swell with the bad cells. After enough swelling, the bad cells go to another adjacent node, and/or rupture the node lining (extracapsular spread), freeing the culprits to wreak havoc.

What happens if the one node swells to over 3 cm, does not rupture, and maintains the boundary, not allowing any bad cells to leave, and is then surgically removed?

This is what happened to me... my only symptom was a swollen node--fna was negative, node was growing...when this node was sugically removed, it was sent to pathology while I was still in the OR, and scca was found. Searching for the primary, they removed my tonsil, salivary gland, and a chain of other nodes. The pathologist found a found a small tonsillar tumor, no ecs, and no other positive nodes.

So, again, the question is positive nodes--why are these so important to a prognosis? Is it because
--they are indicative of an agressive cancer?

--they indicate that the cancer has already spread, and is most likely elsewhere in the head/neck/body (microscopic mets)?

Again, any practical experience is appreciated.

Thank you in advance,


Oscar