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.

Rational choice of neck dissection in clinically N0 patients with supraglottic cancer

“…The eligibility criteria were as follows: (a) the patient had pathologically proven squamous cell carcinoma of the supraglottic larynx; (b) the patient underwent a preoperative examination that revealed cN0, which was diagnosed using the evaluation criteria proposed by Kowalski et al, 13 with a clinical examination that revealed that the lymph nodes were <2 cm in diameter and soft and a radiographic examination (ultrasonography, CT or MRI) that showed that no lymph nodes were >1 cm in diameter; and (c) the patient underwent high-quality neck dissection. The study was approved by the institutional ethic committee.…”

Risk factors for salvage surgery failure in oral cavity squamous cell carcinoma

“…Recurrence of oral cavity SCC occurs in approximately 25% to 45% of cases and in up to 50% of cases with stage III and IV tumors . Salvage surgery, if feasible, is still the best treatment option for better disease‐free survival rates .…”

Discovery of potential serum protein biomarkers for lymph node metastasis in oral cancer

“…Oral squamous cell carcinoma (OSCC) frequently metastasizes to the neck lymph nodes, and the presence of cervical lymph node metastasis represents the most important predictor of the patient's survival. In order to develop successful treatment plans for a patient with OSCC, it is essential to determine if the cancer cells have spread to the neck lymph nodes . Nevertheless, accurate assessment of lymph node metastasis in patients with oral/head and neck cancer seems to be very challenging.…”