Predictive factors of occult neck metastasis in patients with oral squamous cell carcinoma

Bittar, Renato Fortes; Ferraro, Homero Penha; Ribas, Marcelo H.; Lehn, Carlos Neutzling

doi:10.1016/j.bjorl.2015.09.005

Cited by 22 publications

(18 citation statements)

References 28 publications

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“…Sometimes the lymph nodes are negative through clinical examinations such as palpation, B-ultrasonography, CT and MRI, but there are micrometastases in the lymph nodes after pathological examination after neck dissection, which is called occult lymphatic metastasis. About 20% to 40% of early stage oral cancer patients have occult cervical lymph node metastasis 4.OSCC is mainly metastasized through lymphatic channels. Related research 5-7 points out that once patients with oral squamous cell carcinoma are diagnosed with neck lymph node metastases, their survival rate can be significantly reduced.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Analysis of Pathologically Confirmed Cervical Lymph Nodes Metastasis in Oral Squamous Cell Carcinoma Patients with Clinically Negative Cervical Lymph Node: Results from a Cancer Center of Central China

Li¹,

Liu²,

Yuan³

et al. 2019

J. Cancer

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Objective : To explore the risk factors of cervical lymph node metastasis in oral squamous cell carcinoma (OSCC) patients with clinical negative cervical lymph nodes(cN0) and provide a reference for clinical treatment. Methods : The clinical data of 161 OSCC patients with cN0 were retrospectively analyzed. All patients underwent extended primary resection combined with cervical lymph node dissection. The level and number of cervical lymph node metastasis were confirmed by postoperative pathology. The risk factors of cervical lymph node metastasis in patients were analyzed by univariate and multivariate Logistic regression analysis. Results : Thirty-one out of 161 cases (19%) were confirmed cervical lymph node metastasis. Among them, there were 28 cases of lymph node metastasis in one cervical level and 3 cases in two cervical levels. A total of 42 positive lymph nodes were detected in 34 cervical levels. The level number of positive areas in the IA, IB, IIA, IIB, III, IV and V levels was 2, 15, 12, 1, 4,0, and 0, respectively. The corresponding regional metastasis rates were 5.9%, 44.1%, 35.3%, 2.9%, 11.8%, 0% and 0%, respectively. The number of positive lymph node metastases in the corresponding levels were 2, 17, 17, 1, 5, 0, and 0 respectively. Univariate analysis showed that gender, age, lesion location, T stage, and perineural invasion/lymphvascular invasion (PNI/PVI) had no significant effect on cervical lymph node metastasis ( P >0.05). The growth pattern, degree of differentiation, depth of invasion, neutrophil/lymphocyte ratio (NLR) and the short/long axis diameter ratio (S/L ratio) of lymph nodes were important factors influencing the cervical lymph node metastasis in cN0 OSCC patients ( P <0.05). Multivariate Logistic regression analysis indicated that the growth pattern, degree of differentiation, depth of invasion, NLR, and the S/L ratio of lymph nodes were independent risk factors for cervical lymph node metastasis ( P <0.05). Conclusion : The growth pattern, degree of differentiation, depth of invasion, neutrophil/lymphocyte ratio, and the short/long axis diameter ratio of lymph nodes were the independent risk factors for pathological cervical lymph node metastasis in oral squamous cell carcinoma patients with cN0. If patients with the above risk factors receive nonstandard radical neck dissection or no dissection, it may be necessary for them to receive the corresponding regional postoperative radiotherapy.

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Section: Introductionmentioning

confidence: 99%

Risk Factors Analysis of Pathologically Confirmed Cervical Lymph Nodes Metastasis in Oral Squamous Cell Carcinoma Patients with Clinically Negative Cervical Lymph Node: Results from a Cancer Center of Central China

Li¹,

Liu²,

Yuan³

et al. 2019

J. Cancer

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“…However, this is recognized to be associated with a more aggressive tumor and with a poorer prognosis in several malignancies, such as head and neck tumors and prostate cancer. [4][5][6][7][8] Regarding gastric cancer, PNI's prognostic value has not reached any general consensus, and the role of its positivity on predicting outcomes after curative gastric resection for cancer is still under debate. Bilici et al 9 found that the median survival of PNI-positive patients was worse than those having PNI-negative cancers and demonstrated that this is a useful prognostic factor for curative gastric cancer surgery.…”

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confidence: 99%

Influence of perineural invasion in predicting overall survival and disease-free survival in patients With locally advanced gastric cancer

Aurello

Berardi

Tierno

et al. 2017

The American Journal of Surgery

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“…Various references have demonstrated the role of histopathologic parameters of the primary tumor, such as tumor size [25][26][27], DOI [25,26,28], tumor thickness [25,27,28], differentiation grade [25,26], perivascular/perineural invasion [27,29] as possible predictors of occult neck metastasis. Our study confirms the role of tumor size, differentiation grade and perivascular/perineural invasion in accurately staging the clinically negative neck in early-stage OSCC of the tongue.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment Blood Markers in the Prediction of Occult Neck Metastasis: A 10-Year Retrospective Study

Ventura¹,

Barros²,

Salgado³

et al. 2021

Cureus

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The purpose of this study was to clarify the role of inflammatory blood markers in the management of earlystage (T1-T2) oral squamous cell carcinoma (OSCC) of the tongue in patients with a clinically negative neck. Materials and methodsWe undertook a retrospective chart review of 102 patients with early-stage OSCC of the tongue, subjected to tumor resection and elective neck dissection. Based on postsurgical histopathological examination results, we divided our cohort into pN+ and pN0 groups. Afterwards, we analyzed the role of pretreatment inflammatory blood markers in predicting occult neck metastasis. We also evaluated neutrophil-lymphocyte ratio (NLR) association with the depth of invasion (DOI) of the primary tumor. ResultsWe found a significant association of NLR (p=0.001) and monocyte-lymphocyte ratio (p=0.011) with neck status on univariate analysis. Multivariate analysis showed that only NLR (p=0.02) was an independent risk factor for occult metastasis among inflammatory blood markers. Receiver Operating Characteristic curve analysis and Younden's Index determined the NLR value of 2.96 as the most adequate cut-off value for neck status prediction. NLR values of pretreatment workup also had a significant association with the DOI of the primary tumor (p=0.018). ConclusionOur study supports the role of pretreatment NLR in predicting occult neck metastasis in early-stage OSCC of the tongue. It also sheds some light over the potential of NLR as a predictor of the primary tumor's DOI.

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Predictive factors of occult neck metastasis in patients with oral squamous cell carcinoma

Cited by 22 publications

References 28 publications

Risk Factors Analysis of Pathologically Confirmed Cervical Lymph Nodes Metastasis in Oral Squamous Cell Carcinoma Patients with Clinically Negative Cervical Lymph Node: Results from a Cancer Center of Central China

Risk Factors Analysis of Pathologically Confirmed Cervical Lymph Nodes Metastasis in Oral Squamous Cell Carcinoma Patients with Clinically Negative Cervical Lymph Node: Results from a Cancer Center of Central China

Influence of perineural invasion in predicting overall survival and disease-free survival in patients With locally advanced gastric cancer

Pretreatment Blood Markers in the Prediction of Occult Neck Metastasis: A 10-Year Retrospective Study

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