Lingual Lymph Node Metastases as a Prognostic Factor in Oral Squamous Cell Carcinoma-A Retrospective Multicenter Study.

Masahiro Kikuchi,Keigo Honda,Yoshiharu Kitani,Kazuyuki Ichimaru,Takashi Tsujimura,Hiroyuki Harada,Shogo Shinohara,Koichi Omori,Yohei Kumabe,Ryusuke Hori,Tsuyoshi Kojima,Ryo Asato,Masanobu Mizuta,Morimasa Kitamura,Koji Ushiro,Kiyomi Hamaguchi,Hisanobu Tamaki

doi:10.3390/medicina57040374

Abstract

Backgrounds and Objectives: The epidemiology and prognostic role of lingual lymph node (LLN) metastasis in patients with oral squamous cell carcinoma (OSCC) remain unclear. Here, we aimed to analyze the clinicopathological features, risk factors, and prognostic role of LLN metastasis in patients with OSCC. Materials and Methods: In total, 945 patients with OSCC were retrospectively analyzed. Clinicopathological features were compared between patients with and without LLN metastasis. The risk factors of LLN metastasis and its effects on survival outcomes were evaluated using multi-variate analysis. Results: LLN metastasis was noted in 67 patients (7.1%). Habitual alcohol consumption and clinical neck node metastasis were independent risk factors for LLN metastasis. LLN metastasis was an independent prognostic factor for disease-free and overall survival, although LLN dissection did not improve survival outcomes. Conclusion: LLN metastasis is an independent adverse prognostic factor. Further prospective studies are needed to fully assess the extent of LLN dissection required in OSCC patients.

Highlights

Lymph of the anterior oral cavity is drained primarily into the level I lymph nodes
Multivariate logistic regression analysis revealed that habitual alcohol consumption and neck node metastasis were independent risk factors for lingual lymph node (LLN) metastasis (Table 2)
LLN metastasis usually presents with lingual cancer in an advanced stage [14], but we showed that 24 of 405 patients with non-lingual oral cancer (5.9%) exhibited LLN metastasis

Summary

Introduction

Lymph of the anterior oral cavity is drained primarily into the level I lymph nodes. Drainage from the lateral oral tongue and posterior floor of the mouth is directed toward level II lymph nodes [1]. In 1985, Ozeki et al [2] reported three cases of tongue cancer with LLN metastasis within the lingual musculature. Since this form of metastasis has received more attention from clinicians because LLNs can be left behind after a standard (modified/radical) neck dissection owing to their location (beyond the area of dissection)

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Discussion

Conclusion