Pattern of Invasion and Invasive Front Grading Score as Predictive Factors of Late Cervical Lymph Node Metastasis in Surgically Treated Stage I-II Tongue Carcinomas

Abstract

Cervical nodal metastasis has a major influence on survival in squamous cell carcinoma (SCC) of the tongue. However, predictive factors for metastasis remains inconclusive, especially in stage I-II SCC of tongue. This study analyzed the clinicopathologic factors associated with late nodal metastases in patients with stage I-II SCC of tongue. The clinicopathologic factors of 62 consecutive patients between January 1998 and December 2001 with surgically treated stage I-II SCC of the tongue were reviewed prospectively, and the factors predicting late cervical nodal metastasis were analyzed. All patients were treated with partial glossectomy without elective neck dissection. Fourteen of 62 (22.6%) developed late cervical nodal metastases within median follow-up of 36 months. Thirteen patients (92%) developed late nodal metastases within 13 months. In Cox regression analysis, pattern of invasion at the invasive tumor front and invasive front grading score had predictive values for late nodal metastasis. Patients who are surgically treated for stage I-II SCC of tongue with diffused invasive pattern at invasive tumor front and high invasive grading score should be carefully followed up, and delayed elective neck dissection after partial glossectomy should be carried out in selective patients.