Predictive Markers for Late Cervical Lymph Node Metastasis in Patients with N0 Squamous Cell Carcinoma of the Tongue

Abstract

Objective: To find useful markers for predicting late cervical metastasis in patients with N0 squamous cell carcinoma of the tongue.Materials and Methods: The clinicopathological features of 57 consecutive patients with previously untreated N0 squamous cell carcinoma of the tongue were reviewed. Thirty patients had T1 disease, 20 had T2 disease, and 7 had T3 disease. All patients were treated with partial glossectomy without elective neck dissection. Clinicopathological factors were analysed to determine the factors predicting late cervical lymph node metastasis.Results: The overall cervical lymph node metastasis rate was 19.3%. The clinicopathologic factors significantly associated with the development of cervical lymph node metastasis were tumour size (30 mm), tumour depth (4 mm), differentiation (moderate), mode of invasion (G4C 4D), microvascular invasion (present), muscle invasion (present), and invasive front grading (12 points). In a multivariate logistic regression analysis, invasive front grading ≥12 points in squamous cell carcinoma of the tongue with a tumour depth ≥4 mm had predictive value for late cervical lymph node metastasis.Conclusion: The results indicate that patients with N0 invasive tongue carcinoma with a tumour depth ≥4 mm or invasive front grading ≥12 points should be considered at high risk for late cervical lymph node metastasis. These factors should be considered in the decision to electively treat the neck.