Abstract
BackgroundThe aims of this study were to determine intra (ILVD) and peritumoral (PLVD) lymphatic vessel density (LVD), and to investigate the relationship of LVD with occult metastasis and prognosis.MethodsEighty-seven oral squamous cell carcinomas, in clinical stages I or II, arising in the tongue or floor of the mouth were stained with podoplanin. Lymphatic vessels were quantified in intra and peritumoral areas by sequential analysis and hot spot evaluation. Associations of the ILVD and PLVD with clinicopathologic parameters were determined by Chi-square or Fisher’s exact test. The 5 and 10-year survival rates were calculated by the Kaplan–Meier and compared using the log-rank test.ResultsNo significant association was observed between ILVD or PLDV and clinicopathologic variables including occult lymph node metastasis, or clinical follow-up. However, ILVD showed a significant association with regional recurrence (p = 0.040). The perineural invasion was associated with PLVD (p = 0.041). Disease-specific (p = 0.044) and disease-free survivals (p = 0.016) had significant association with PLVD.ConclusionsThe intra or peritumoral lymphatic vessel density had no predictive value for occult lymph node metastasis in the early stages of oral cancer arising in the tongue or floor of mouth.
Highlights
Oral squamous cell carcinoma (OSCC), among other solid malignant tumors, preferentially disseminate through the complex lymphatic system into the regional basin
The occurrence of metastasis is a critical event with severe negative impact on the prognosis of the patient [5]
Based on the International Union Against Cancer (UICC) classification of oral cavity carcinomas, most of the tumors were classified as T2 (67.8%)
Summary
Oral squamous cell carcinoma (OSCC), among other solid malignant tumors, preferentially disseminate through the complex lymphatic system into the regional basin. From this point, cancer cells may be transported into the circulation and spread to distal organs and tissues through blood vessels [1, 2]. The ability of the tumoral cells to transpose the lymphatic wall is considered one of the earliest events in metastatic disease [3, 4]. TNM system takes into account only clinical aspects of the tumor and does not consider its molecular characteristics [6]. TNM system has been shown to poorly predict the prognosis of early OSCC [7]. The aims of this study were to determine intra (ILVD) and peritumoral (PLVD) lymphatic vessel density (LVD), and to investigate the relationship of LVD with occult metastasis and prognosis
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