Abstract
Squamous cell carcinoma (SCC) of the tongue rarely metastasizes to the lingual lymph nodes (LLNs), which are inconstant nodes and often situated outside the areas of basic tongue tumor surgery. The current study evaluated the clinicopathological features and prognostic impact of LLN metastasis (LLNM), compared to that of cervical lymph node metastasis, in patients with tongue SCC. A total of 608 patients underwent radical surgery for tongue SCC at our department between January 2001 and December 2016. During neck dissection, we scrutinized and resected lateral LLNs, when present. Of the 128 patients with lymph node metastasis, 107 had cervical lymph node metastasis and 21 had both cervical lymph node metastasis and LLNM. Univariate analysis demonstrated that LLNM was significantly associated with the adverse features of cervical lymph node metastasis. The 5-year disease-specific survival (5y-DSS) was significantly lower in patients with LLNMs than in those without LLNMs (49.0% vs. 88.4%, P < 0.01). Moreover, Cox proportional hazards model analyses revealed that cervical lymph node metastasis at level IV or V and LLNM were independent prognostic factors for 5y-DSS. LLNM has a strong negative impact on survival in patients with tongue SCC. An advanced status of cervical lymph node metastasis may predict LLNM.
Highlights
Squamous cell carcinoma (SCC) of the tongue rarely metastasizes to the lingual lymph nodes (LLNs), which are inconstant nodes and often situated outside the areas of basic tongue tumor surgery
Statistical analysis of the correlation between LLN metastasis (LLNM) and clinicopathological features suggested that pathologic adverse features of cervical lymph node metastasis may be a reliable predictor of LLNM; (3) The 5-year disease-specific survival (5y-disease-specific survival (DSS)) in patients with LLNM was significantly poorer than that in patients without LLNM
T stage and occult cervical lymph node metastasis were associated with LLNM in patients with cT1-2N0 tongue SCC18, whereas T stage, tumor differentiation, perineural invasion, lymphovascular invasion, and cervical lymph node metastasis were associated with LLNM in patients with cT2-4 tongue S CC19
Summary
Squamous cell carcinoma (SCC) of the tongue rarely metastasizes to the lingual lymph nodes (LLNs), which are inconstant nodes and often situated outside the areas of basic tongue tumor surgery. The current study evaluated the clinicopathological features and prognostic impact of LLN metastasis (LLNM), compared to that of cervical lymph node metastasis, in patients with tongue SCC. Small when p resent[8,10,11,12] Due to their anatomic locations, LLNs are often situated outside the areas of surgical resection of the primary tongue tumor and neck dissection[8,10,13,14,15,16,17]. Previous studies have reported the incidence of median and lateral lingual lymph node metastasis (LLNM) to be 0.7–3.0%8,11,13 and 1.4–14.3%11,13,17–19, respectively. The present study aimed to evaluate the clinicopathological features associated with LLNM and impact of LLNM, compared to that of cervical lymph node metastasis, on survival in patients with tongue SCC
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