Influence of cervical lymph node metastases on therapy and prognosis of lingual cancer

Lawrence, Knowles B.; Murray, Joseph E.; Friedman, Paul M.

doi:10.1016/0002-9610(64)90136-9

“…(2) patients not previously treated; and (3) patients who had curative surgery as their initial treatment. Cases that had at least one of the following characteristics were not considered eligible for study: (1) contraindication for surgery (inoperable or unresectable); (2) distant metastases at the time of admission; (3) presence of other simultaneous primary tumors; and (4) patients managed with preoperative radiotherapy and neoadjuvant or adjuvant chemotherapy.…”

Section: Methodsmentioning

confidence: 99%

“…Notwithstanding the high level of information, the prognostic significance of the distribution of ipsilateral cervical metastases and the presence of contralateral metastases still raises a series of doubts. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The high incidence rate of cervical metastases in squamous carcinoma of the oral cavity is a strong argument in favor of an elective treatment of the ipsilateral side of the neck. However, no consensus has been reached on the need for con-…”

mentioning

confidence: 99%

Prognostic significance of the distribution of neck node metastasis from oral carcinoma

Kowalski

¹

,

Bagietto

²

,

Lara

³

et al. 2000

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Background Carcinoma of the oral cavity presents a high risk for neck metastasis, which reduces the probability of regional control and survival. Objectives The main objective of this study is to analyze prognostic implications of the distribution of neck metastasis in 513 patients with squamous cell carcinoma of the oral cavity. Patients and methods All patients underwent surgery from 1970–1992. Tumor stages were I, 63; II, 120; III, 173; and IV, 157. Neck dissections were performed in 448 patients (115 bilateral). Results By use of multivariate regression techniques the level of lymph node involvement was the most important prognostic factor (relative risks from 1.8 to 2.5). The following variables were also associated with prognosis: mobility of lymph nodes, sex, T stage, age, and tumor thickness. Conclusions The level of ipsilateral lymph node involvement was the most significant prognostic factor patients with in oral cancer who underwent surgical treatment. A significant decrease in survival also was seen with regard to the involvement of multiple contralateral lymph nodes. Our results support the indication of elective neck dissections in high‐risk patients because among the cases that had metastases at follow‐up, 50% were not candidates for salvage treatment. © 2000 John Wiley & Sons, Inc. Head Neck 22: 207–214, 2000.

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“…Nodal metastasis can decrease survival substantially (1, 2). Patients with contralateral lymph node metastasis have a particularly poor prognosis (1, 3). It is known that extension of the primary tumor to the midline increases the risk of contralateral lymph node metastasis (4, 5) and other clinicopathological predictors have been examined with varying results (5-9).…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Importance of Midline Involvement in Oral Tongue Cancer

Lloyd

¹

,

Yu

²

,

Wilson

³

et al. 2012

American Journal of Clinical Oncology

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Objectives To examine the importance of midline involvement and other clinicopathological factors in predicting the rate of contralateral lymph node metastasis and survival in oral tongue squamous cell carcinoma. Methods We used SEER data to identify a cohort of 5430 patients with laterally rising tumors. Clinicopathological factors examined as potentially predictive of contralateral lymph node metastasis included extension to midline, T classification, anatomical site, grade, histological sub-type, race, age, and gender. Survival analysis included the above factors plus lymph node status. Results T1 tumors and lateral T2 and T3 tumors had rates of contralateral lymph node metastasis ranging from 0.7-0.9% on presentation. T4 lesions and midline crossing T2 and T3 lesions had corresponding rates of 8.3 to 13.0%. Primary extension across the midline was associated with a mean survival about half that of strictly lateral tumors and its significance was maintained in multivariate analysis. Conclusions Patients with T1 disease or T2-3 disease that doesn’t cross midline are in a different prognostic class from patients with T2-3 disease that crosses midline or T4 tumors. These results give the strongest evidence to date that involvement of the midline is a powerful predictor for decreased survival in oral tongue squamous cell carcinoma.

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The high incidence rate of cervical metastases in squamous carcinoma of the oral cavity is a strong argument in favor of an elective treatment of the ipsilateral side of the neck. The most significant prognostic factors are site and size of the primary tumor and the variables related to lymph node metastases, among them the extent, number, location, and transcapsular involvement.…”

mentioning

confidence: 99%

Prognostic significance of the distribution of neck node metastasis from oral carcinoma

Kowalski¹,

Bagietto²,

Lara³

et al. 2000

View full text Add to dashboard Cite

Background Carcinoma of the oral cavity presents a high risk for neck metastasis, which reduces the probability of regional control and survival. Objectives The main objective of this study is to analyze prognostic implications of the distribution of neck metastasis in 513 patients with squamous cell carcinoma of the oral cavity. Patients and methods All patients underwent surgery from 1970–1992. Tumor stages were I, 63; II, 120; III, 173; and IV, 157. Neck dissections were performed in 448 patients (115 bilateral). Results By use of multivariate regression techniques the level of lymph node involvement was the most important prognostic factor (relative risks from 1.8 to 2.5). The following variables were also associated with prognosis: mobility of lymph nodes, sex, T stage, age, and tumor thickness. Conclusions The level of ipsilateral lymph node involvement was the most significant prognostic factor patients with in oral cancer who underwent surgical treatment. A significant decrease in survival also was seen with regard to the involvement of multiple contralateral lymph nodes. Our results support the indication of elective neck dissections in high‐risk patients because among the cases that had metastases at follow‐up, 50% were not candidates for salvage treatment. © 2000 John Wiley & Sons, Inc. Head Neck 22: 207–214, 2000.

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Influence of cervical lymph node metastases on therapy and prognosis of lingual cancer

Cited by 12 publications

References 2 publications

Prognostic significance of the distribution of neck node metastasis from oral carcinoma

Prognostic significance of the distribution of neck node metastasis from oral carcinoma

The Prognostic Importance of Midline Involvement in Oral Tongue Cancer

Prognostic significance of the distribution of neck node metastasis from oral carcinoma

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