Distribution of metastatic regional lymph nodes in squamous cell carcinoma of the oral commissure and its implications for treatment in the neck

Squamous cell carcinoma (SCC) of the oral commissure comprises 6%–8.5% of all tumours of the lip,1 and despite its lower prevalence, it has the poorest survival among all such subsites.2 Although the pathophysiological basis for the lower survival of patients who have primary lesions of the commissure is not entirely clear, evidence suggests that there is a higher incidence of regional nodal metastases compared with other subsites of SCC in the lip.3 It is critical, therefore, for oral and maxillofacial surgeons, head and neck surgeons, and radiation oncologists to understand the patterns of lymphatic distribution in the neck.

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