Incidence of Micrometastasis and Isolated Tumour Cells in Clinicopathologically Node-Negative Head and Neck Squamous Cell Carcinoma

Majumdar, Kinjal Shankar; Rao, Vishal U.S.; Prasad, Rachana; Ramaswamy, Veena; Sinha, Piyush; Subash, Anand

doi:10.1007/s12663-019-01239-4

Cited by 18 publications

(16 citation statements)

References 15 publications

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“…Patients with OTSCC have a high morbidity and poor prognosis even when tumors are small [7]. For low-stage tumors (T1-T2N0M0), as much as 20% of patients may develop neck metastasis and recurrence within 2 years [8,9]. In Europe the five-year relative survival for oral cancer is around 50% [10].…”

Section: Introductionmentioning

confidence: 99%

Tumor budding score predicts lymph node status in oral tongue squamous cell carcinoma and should be included in the pathology report

et al. 2020

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Background The majority of oral cavity cancers arise in the oral tongue. The aim of this study was to evaluate the prognostic value of tumor budding in oral tongue squamous cell carcinoma, both as a separate variable and in combination with depth of invasion. We also assessed the prognostic impact of the 8th edition of the American Joint Committee on Cancer's TNM classification (TNM8), where depth of invasion (DOI) supplements diameter in the tumor size (T) categorization. Methods Patients diagnosed with primary oral tongue squamous cell carcinoma were evaluated retrospectively. Spearman bivariate correlation analyses with bootstrapping were used to identify correlation between variables. Prognostic value of clinical and histopathological variables was assessed by Log rank and Cox regression analyses with bootstrapping using 5-year disease specific survival as outcome. The significance level for the hypothesis test was 0.05. Results One-hundred and fifty patients had available material for microscopic evaluation on Hematoxylin and Eosin-stained slides and were included in the analyses. Reclassification of

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Section: Introductionmentioning

confidence: 99%

Tumor budding score predicts lymph node status in oral tongue squamous cell carcinoma and should be included in the pathology report

et al. 2020

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“…Thirdly, many studies emphasizing oncologic safety without dissecting level IIb seem to have overlooked the presence of micro-metastasis (MM) or isolated tumour cells (ITC) in the pN0 nodes 54 . In a recent study, the rate of MM was as high as 9% in pN0 cases, the risk being highest in level IB and IIA 55 . Moreover, current pre-operative diagnostics to detect nodal micro-metastasis are not definitive.…”

Section: Discussionmentioning

confidence: 92%

Predictive modelling of level IIb lymph node metastasis in oral squamous cell carcinoma

Yang

Son

Lee

et al. 2021

Sci Rep

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The aim of the present study was to examine the conditions, characteristics, and risk factors of level IIb lymph node metastases in oral squamous cell carcinoma and to formulate surgical criteria for level IIb lymph node dissection. We analyzed clinical and pathological records for 541 oral squamous carcinoma patients in relation to level IIb metastasis. Univariate and multivariate analyses were performed to detect risk factors for level IIb lymph node metastasis; a predictive model was built based on multivariate analysis and tested in a validation group. Univariate and multivariate analyses using the training group indicated that level IIa metastasis and Lymphovascular permeation (LVP) were two independent risk factors for level IIb lymph node metastasis. This model was built and tested in a validation group, the area under the curve being 0.697 (P < .0.001). The model’s sensitivity was 66.7% and specificity was 77.4%. Nomogram incorporating validated variables was developed for level IIb metastasis prediction. Expected survival probabilites were analysed to specify significance of model's variable on patients’ overall survival and recurrence. Level IIb dissection should be performed in patients with level IIa metastasis and LVP. However, thorough consideration of the oncologic safety of omitting level IIb dissection is compulsory.

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“…Figure 6 demonstrates how micrometastases are detected more reliably by performing serial sectioning. Another smaller prospective study analysed 34 neck dissection specimens with serial sectioning and immunohistochemistry (IHC) in addition to standard haematoxylin-eosin staining (HES) and found that 3 patients (8.8%) were upstaged by the additional analysis, with two cases of micrometastases and one patient harbouring ITC [26]. Importantly the identification of these micrometastases did not warrant further treatment beyond the neck dissection which had already been performed [25].…”

Section: Histopathological Analysismentioning

confidence: 99%

Sentinel Lymph Node Biopsy for Early Oral Cavity Squamous Cell Carcinoma

Mendis¹,

Abdul-Razak²

2022

Oral Cancer - Current Concepts and Future Perspectives

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Early stage oral cavity squamous cell carcinoma (OCSCC) has a significant risk of subclinical nodal metastases, which is the strongest independent prognostic factor for regional recurrence and survival. However current preoperative imaging modalities are unable to identify patients with micrometastases, and an observation strategy has been associated with inferior outcomes when compared to an elective neck dissection. Sentinel lymph node biopsy provides a safe and accurate staging procedure to select the patients who benefit from an elective neck dissection, while avoiding unnecessary surgery in the patients who are node negative. There is recent Level II evidence demonstrating equivalent oncological outcomes when compared with elective neck dissection. However, a multidisciplinary approach is required including reliable mapping of the sentinel lymph node, precise surgical technique and comprehensive histopathological analysis to ensure accurate results are obtained.

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Incidence of Micrometastasis and Isolated Tumour Cells in Clinicopathologically Node-Negative Head and Neck Squamous Cell Carcinoma

Cited by 18 publications

References 15 publications

Tumor budding score predicts lymph node status in oral tongue squamous cell carcinoma and should be included in the pathology report

Tumor budding score predicts lymph node status in oral tongue squamous cell carcinoma and should be included in the pathology report

Predictive modelling of level IIb lymph node metastasis in oral squamous cell carcinoma

Sentinel Lymph Node Biopsy for Early Oral Cavity Squamous Cell Carcinoma

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