The topography of cervical lymph node metastases revisited: the histological findings in 526 sides of neck dissection from 439 previously untreated patients

Woolgar, Julia A.

doi:10.1016/j.ijom.2006.10.014

Cited by 99 publications

(70 citation statements)

References 24 publications

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“…16,29,30 Pathological features were similar as well, with most (B70%) patients presenting with T1 or T2 tumors 16,29 and most (B80%) presenting with cervical lymph-node metastases. 31 Despite this very high rate of nodal metastases, the prognosis was quite favorable. Only three patients developed recurrent disease and only one developed distant metastatic disease.…”

Section: Discussionmentioning

confidence: 99%

Undifferentiated carcinoma of the oropharynx: a human papillomavirus-associated tumor with a favorable prognosis

2011

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Undifferentiated carcinoma (undifferentiated carcinoma, nasopharyngeal type, or lymphoepithelial carcinoma) is an uncommon and histologically distinct tumor in the oropharynx, which in Western countries, has been clearly shown not to harbor Epstein Barr virus (EBV). We sought to analyze these tumors for human papillomavirus (HPV) and to examine their clinical outcomes. All cases of oropharyngeal carcinoma diagnosed as 'undifferentiated' or 'lymphoepithelial' were retrieved from the department files at Barnes-Jewish Hospital. After consensus review by all three study pathologists, 16 were found to have diagnostic histological features and to lack distinguishing characteristics of other oropharyngeal cancers. Immunohistochemistry for p16 and p53 and in-situ hybridization for HPV and EBV encoded small RNA were performed. p16-positive but HPV in situ hybridization-negative cases were analyzed by polymerase chain reaction for high-risk HPV types. The results were correlated with pathological findings and clinical follow up. There were 16 patients. The average age was 59.2 years, 14 patients (88%) were smokers, and 13 (81%) had nodal metastases. In all, 14 cases (88%) were p16 positive and 15 (94%) were HPV positive by in situ hybridization and/or polymerase chain reaction. All cases were negative for EBV, and p53 was overexpressed in five (33%), four of which were HPV positive. Disease recurred in only three patients and two of these died with disease at 38 and 136 months, respectively. Three year overall, disease-free, and disease-specific survival rates were 54, 78, and 100%, respectively. In summary, in our patient population, the majority of oropharyngeal undifferentiated carcinomas harbor transcriptionally active HPV but not EBV. Almost all overexpress p16, and few have p53 overexpression. Disease-specific survival is comparable to published rates for other HPV-related oropharyngeal squamous cell carcinoma variants and is better than that of HPV-negative carcinomas.

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Section: Discussionmentioning

confidence: 99%

Undifferentiated carcinoma of the oropharynx: a human papillomavirus-associated tumor with a favorable prognosis

2011

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“…In a retrospective analysis of 66 patients with cancer of the oral cavity at N0-2 stage, Koo et al [29] showed that the rate of contralateral occult metastasis was 8% for T2, 25% for T3, and 18% for T4, whereas no metastasis was observed in the T1 cases. It is also noteworthy that fewer bilateral metastases were seen for T1 tumors compared with more advanced primaries [21] and the patients with bilateral metastases had at least T2 disease or greater [39].…”

Section: Tumor Sizementioning

confidence: 96%

“…Several studies have widely described a correlation between large size at presentation and contralateral metastases, which are associated with an increased risk of poor survival [8,13,21,29,[35][36][37][38][39]. Risks of CLNM for cases of tumors at stage T4 and patients seen with two involved sites are significantly higher in relation to those with tumors confined to the original site or at early stage.…”

Section: Tumor Sizementioning

confidence: 99%

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma

et al. 2011

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Oral squamous cell carcinoma (OSCC) has a high incidence of cervical micrometastases and sometimes metastasizes contralaterally because of the rich lymphatic intercommunications relative to submucosal plexus of oral cavity that freely communicate across the midline, and it can facilitate the spread of neoplastic cells to any area of the neck consequently. Clinical and histopathologic factors continue to provide predictive information to contralateral neck metastases (CLNM) in OSCC, which determine prophylactic and adjuvant treatments for an individual patient. This review describes the predictive value of clinical-histopathologic factors, which relate to primary tumor and cervical lymph nodes, and surgical dissection and adjuvant treatments. In addition, the indications for elective contralateral neck dissection and adjuvant radiotherapy (aRT) and strategies for follow-up are offered, which is strongly focused by clinicians to prevent later CLNM and poor prognosis subsequently.

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“…In cancers of the oral cavity, high histopathological malignancy grade is associated with increased risks of metastases to cervical lymph nodes, lung and bone, which greatly impact the prognosis [1][2][3][4][5][6] . Moreover, early detection of these cancers is desirable so that treatment can aim at conservation of oral functions and improvement of prognosis.…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical Study of Differential Expressions of Cytokeratin-13, -14, -17 and p53 in Epithelial Dysplasia and Carcinoma of the Tongue

Okada

Moride

2010

J. Hard Tissue Biology.

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In cancers of the oral cavity, high histological malignancy grade is associated with higher risk of cervical lymph nodes, lung and bone metastases, which have great impact on the prognosis. Furthermore, early detection of these cancers is desirable so that treatment can aim at conserving oral functions and improving prognosis. It is known that several percent of leukoplakia that develop in the tongue become cancerous. Leukoplakia is a clinical diagnostic term, and histopathologically most cases show hyperkeratosis with epithelial dysplasia or hyperkeratosis without epithelial dysplasia. On the other hand, difficulties in histopathological diagnosis of severe epithelial dysplasia and carcinoma in situ are often encountered. In recent years, immunohistochemical staining of cytokeratins (CK), p53 and Ki-67 for precancerous lesions and squamous cell carcinoma (SCC) of the oral cavity has been reported. However, few reports have applied a combination of several immunohistochemical stainings to diagnosis. In the present study, with the objective to achieve a higher precision in histopathological diagnosis, we conducted and compared the immunohistochemical stainings of CK13, CK17, CK14 and p53 in 10 cases each of hyperkeratosis without epithelial dysplasia, hyperkeratosis with epithelial dysplasia, carcinoma in situ, and SCC in the tongue. The following results were obtained. CK13 was positive in all 10 cases of hyperkeratosis without epithelial dysplasia, and negative in all cases of hyperkeratosis with epithelial dysplasia, carcinoma in situ, and SCC. CK17 was negative in all 10 cases of hyperkeratosis without epithelial dysplasia, and was positive in all 10 cases of hyperkeratosis with epithelial dysplasia as well as 10 cases of carcinoma in situ and 9 of 10 cases of SCC. CK14 was negative or positive only in the basal cell layer or a few rows of cells in spinous layer adjacent to the basal cell layer in cases of hyperkeratosis without epithelial dysplasia, but was positive in all the epithelial layers in all 10 cases of hyperkeratosis with epithelial dysplasia, and also positive in the tumor in all 10 cases each of carcinoma in situ and SCC. For p53, positive reaction was observed in some cells of the basal cell layer in 2 of 10 cases of hyperkeratosis without epithelial dysplasia, while high positive rates were found in hyperkeratosis with epithelial dysplasia (10 of 10 cases) and SCC (9 of 10 cases). On the other hand, only 5 of 10 cases of carcinoma in situ were positive for p53. In conclusion, although the histopathological diagnosis of epithelial dysplasia and carcinoma in situ is based on hematoxylin-eosin stained sections, immunostaining and evaluation of CK13, CK17, CK14 and p53 are useful as an adjunct to histopathological diagnosis.

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The topography of cervical lymph node metastases revisited: the histological findings in 526 sides of neck dissection from 439 previously untreated patients

Cited by 99 publications

References 24 publications

Undifferentiated carcinoma of the oropharynx: a human papillomavirus-associated tumor with a favorable prognosis

Undifferentiated carcinoma of the oropharynx: a human papillomavirus-associated tumor with a favorable prognosis

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma

Immunohistochemical Study of Differential Expressions of Cytokeratin-13, -14, -17 and p53 in Epithelial Dysplasia and Carcinoma of the Tongue

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