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

Abstract

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.

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

“…Among these patients, 449 (41.2%) were diagnosed with PTMC by pathology, and all the patients had preoperatively undergone US. Inclusion criteria referred to the clinical evaluation criteria of cervical lymph nodes defined by Kowalski et al (10). The patients matching the following conditions could be diagnosed as cN0 PTMC: i) No palpable enlarged lymph node on clinical examination, or the maximum diameter of the enlarged lymph node was <2 cm with a soft texture; ii) no visible enlarged lymph node in the imaging exam-ination, the maximum diameter of the enlarged lymph node was <1 cm or the maximum diameter was 1-2 cm with no central liquefaction necrosis, peripheral enhancement or disappeared fat gap adjacent to the lymph node.…”

Clinicopathological significance of carbonic anhydrase 9, glucose transporter-1, Ki-67 and p53 expression in oral squamous cell carcinoma

“…Many oral malignant neoplasms (oral cancer) are squamous cell carcinoma, and most of them develop in the tongue, with slightly higher frequency in men than in women (1). Approximately 50% of patients have cervical lymph node metastasis at the time of diagnosis, and the outcome of these patients is poor (2)(3)(4). In addition, the 5-year disease-free survival rate of patients with oral cancer decreases from 75% in stage I to 22% in Stage IV (5), indicating that it is important to find markers for early detection of cancers and to develop more effective treatments.…”

Neck treatment of patients with early stage oral tongue cancer

“…In our report the skip metastatic rate was lower compared with that reported in previous studies. 9,14,45,46 However, in our study all patients were staged with the use of CT/MR imaging. In the light of our data, routine dissection of level IV lymph node alongside SOND can provide little benefit to patients with early-stage tongue cancer.…”