Evaluation of histopathologic parameters in predicting cervical lymph node metastasis of oral and oropharyngeal carcinomas

Shingaki, Susumu; Suzuki, Ichirô; Nakajima, Tamio; Kawasaki, Tateharu

doi:10.1016/0030-4220(88)90318-0

Cited by 99 publications

(45 citation statements)

References 24 publications

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“…A highly significant association between the presence of lymphovascular invasion and nodal metastases in elective neck dissections was also shown in studies by Shingaki et al, Pimenta Amaral et al, Brown et al, and Sparano et al 16,17,24,29 Another strong predictor for SLNM in our study was a dissolute growth pattern at the infiltrating tumor front, with PPV of 83.3% and odds ratio of 75. The histologic assessment and classification of the mode of invasion is not easy and warrants effort and experience from the pathologists.…”

Section: Discussionsupporting

confidence: 63%

“…15,23,27,35,43 However, others were able to do so. 16,17,21,22,29,33,42 For the parameter muscle invasion there is only the report by Pimenta Amaral et al showing an association with nodal metastases. 17 The reports for the parameter lymphoplasmacytic infiltration are again controversial in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…12,[15][16][17] For the statistical analysis tumors graded G1 were compared with the pooled tumors graded G2 and 3.…”

Section: Histopathologymentioning

confidence: 99%

“…The most promising factor emerging from these studies seemed to be the depth of tumor infiltration. [14][15][16][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Even nowadays, many centers still rely on cutoff values of 4 or 5 mm of tumor depth for indication of elective neck treatment. With regard to the much more focused and precise histological staging of sentinel lymph nodes in contrast to nodes in neck dissection specimens, the aim of this study was to assess whether any of the formerly evaluated clinical or histologic factors in the primary tumors were still significantly predictive of occult disease in the context of SNB.…”

mentioning

confidence: 99%

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Evaluation of Clinical and Histomorphological Parameters as Potential Predictors of Occult Metastases in Sentinel Lymph Nodes of Early Squamous Cell Carcinoma of the Oral Cavity

2009

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Background. Sentinel node biopsy (SNB) for cN0 early squamous cell carcinoma (SCC) of the oral cavity has been validated by numerous studies. Around 30% of SNB will detect occult disease. Several clinical and morphological features of the primary tumor have been claimed to be predictive for occult metastasis in elective neck dissections. The aim of this study was to assess these factors in the context of SNB. Methods. Seventy-eight patients undergoing SNB for T 1/2 oral SCC from the years 2000 to 2007 were prospectively included. Primary tumors were reviewed for the following morphological and clinical parameters: grade of differentiation, tumor depth, tumor thickness, perineural invasion, lymphatic invasion, vascular invasion, muscle invasion, lymphoplasmacytic infiltration, and mode of invasion, age, gender, primary tumor site, tumor side, and cT category. Results. Statistical analysis revealed significance to predict occult metastasis in the SNB for grade of differentiation (P = 0.002), lymphatic invasion (P \ 0.001), and mode of invasion (P \ 0.001). None of the other factors reached significance. The mean tumor depth was 6.45 mm (range 0.72-15.15 mm) and the mean tumor thickness was 7.2 mm (range 0.72-15.15 mm). None of the cutoff values reached significance for predicting occult disease. Conclusions. Tumor depth and tumor thickness failed to achieve statistical significance for prediction of occult metastases in the context of SNB. Patients with cN0 early squamous cell carcinoma of the oral cavity should be offered SNB regardless of their tumor depth and thickness. Poorly differentiated carcinomas, carcinomas with lymphangiosis, and carcinomas with a dissolute mode of invasion show a high probability of positive SNB. Lymph node metastases have been shown to be the strongest prognosticator in head and neck squamous cell carcinoma (HNSCC). The 5-year survival drops considerably from 63-86% in patients with no nodal involvement to 20-36% in patients with lymph node metastases. [1][2][3][4] Whereas therapeutic neck dissection in patients with overt lymph node involvement is considered standard of care, there still exists controversy with regard to elective treatment of the clinically negative neck. Though the benefit of elective neck dissection versus wait-and-see with therapeutic neck dissection in case of nodal relapse has never been proven in large randomized trials, most centers around the world favor an active policy in these situations. The rationale for this lies in the high prevalence of occult disease found on routine elective neck dissection. However, although 20-30% of clinically N0 patients will show occult metastases on elective neck dissection, a considerably large number of patients will remain pathologically N0, and therefore do not benefit from the surgical intervention. 5,6 During the last decade sentinel node biopsy (SNB) has been adopted from the treatment of breast cancer and melanoma, and successfully introduced in the treatment regimen of early oral and oropharyngeal squamous cel...

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

“…12,[15][16][17] For the statistical analysis tumors graded G1 were compared with the pooled tumors graded G2 and 3.…”

Section: Histopathologymentioning

confidence: 99%

mentioning

confidence: 99%

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Evaluation of Clinical and Histomorphological Parameters as Potential Predictors of Occult Metastases in Sentinel Lymph Nodes of Early Squamous Cell Carcinoma of the Oral Cavity

2009

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“…Alguns fatores são importantes para definir o prognóstico dos CEC, como a gradação histológica das lesões (31)(32)(33), o tamanho da lesão (34,35) e até mesmo a consistência tumoral (35). No entanto, o estadiamento de linfadenopatia cervical é o principal fator para determinação do prognóstico destes pacientes (32, 36) e a falha no exame clínico em detectar metástases em linfonodos pode chegar a 40% (37,38).…”

Section: Fatores Prognósticosunclassified

Uso da tomografia por emissão de pósitrons (PET-CT FDG-18F) na avaliação da resposta terapêutica precoce (quimioterapia de indução) nos portadores de carcinoma espinocelular de cabeça e pescoço

Anjos¹

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Gráfico 1 -Sobrevida do paciente após o PET1, segundo o grupo.Gráfico 2 -Curva ROC e estimativas das áreas sob a curva para os grupos de resposta SUV max , SUV med , MTV 40% e TLG 40% . Gráfico 3 -Distribuição percentual do Delta TLG 40Gráfico 4 -Sobrevida dos pacientes após o PET2, segundo o grupo. The ROC curve showed that none of the metabolic parameters showed a significant performance. However, regression analysis showed the SUVmax might be considered a predictive factor of early therapeutic response with a p <0.05. We conclude that the SUVmax can be used as predictive factor to early therapeutic response. However, further studies with larger samples are needed to confirm this finding. Lista de abreviaturas e siglasPalavras chaves (inglês): FDG-18 F PET-CT; HNSCC; induction chemotherapy; early therapeutic response SUMÁRIO

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Markers for Nodal Metastasis in Head and Neck Squamous Cell Cancer

Takes¹,

Jong²,

Alles³

et al. 2002

Arch Otolaryngol Head Neck Surg

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The expression of the investigated genetic markers and histopathological features of primary tumors can supply limited information on the metastatic behavior of tumors. Although the use of markers for regional metastasis would be a welcome additional tool, these results do not warrant the use of these parameters for clinical decision making concerning the treatment of the neck in patients with head and neck squamous cell cancer.

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Evaluation of histopathologic parameters in predicting cervical lymph node metastasis of oral and oropharyngeal carcinomas

Cited by 99 publications

References 24 publications

Evaluation of Clinical and Histomorphological Parameters as Potential Predictors of Occult Metastases in Sentinel Lymph Nodes of Early Squamous Cell Carcinoma of the Oral Cavity

Evaluation of Clinical and Histomorphological Parameters as Potential Predictors of Occult Metastases in Sentinel Lymph Nodes of Early Squamous Cell Carcinoma of the Oral Cavity

Uso da tomografia por emissão de pósitrons (PET-CT FDG-18F) na avaliação da resposta terapêutica precoce (quimioterapia de indução) nos portadores de carcinoma espinocelular de cabeça e pescoço

Markers for Nodal Metastasis in Head and Neck Squamous Cell Cancer

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