Objectives: The aim of this study was to evaluate neck node metastasis and related clinicopathological parameters of primary oral squamous cell carcinoma (OSCC) patients who underwent neck dissections.

Materials and Methods: A descriptive cross-sectional study was conducted compromising 571 records of patients treated at the Oral and Maxillofacial Unit, National Hospital, Galle, Sri Lanka from 2001 to 2020. Data were analyzed using SPSS-26 statistical software package.

Results: The occurrence of neck positivity was 54.1 %. Stages III and IV cancers (OR = 1.79: 95% CI 1.22- 2.63 (p = 0.003), compared with stages 1 and II and types 3 &4 invasive fronts (OR = 1.8: 95% CI 1.1-2.9) (p = 0.030) compared with types 1 & 2 were significantly associated with neck node metastases. Depth of invasion types 2, 3, 4 (> 5 mm) vs type 1 (OR = 7.6, 95% CI = 2.5- 13.7) (p=0.0001) and grade 3 differentiation compared to grade 1 or 2 had significant neck node metastases (OR= 2.8, 95% CI, 1.2-6.4) (p=0.0001). Palatal (OR = 2.91, 95% CI: 1.40-6.04) (p=0.004) and tongue lesions (OR=1.50, 95% CI: 1.03-2.19) (p=0.034) demonstrated higher neck mode metastases compared to other primary sites.

Conclusion: The results confirm that clinicopathological parameters of primary OSCC could assist rational neck dissections decisions.  As advanced staged tumours with aggressive biology were more likely to have nodal involvement and radical neck dissections, early detection and prompt treatment of OSCC become important for countries like Sri Lanka.

Key-words: Oral Squamous cell carcinoma, metastasis, neck dissection, clinic-pathological parameter