Abstract
Neck staging in oral cancer depends on the number of compromised nodes, their size and side of occurrence. ObjectiveThis paper aims to evaluate risk factors for metastatic nodes in levels IV/V and their prognostic impact on patients with oral carcinoma. MethodRetrospective study. Inclusion criteria: pathologist's diagnosis of squamous cell carcinoma, primary tumor in the lower oral cavity, no extension into extraoral sites, no previous treatment, synchronous neck dissection and presence of metastatic nodes. Risk factors for metastasis were evaluated through logistic regression and disease-specific survival and recurrence by survival analysis. Classificatory analysis was performed through recursive partitioning. Results307 patients met the inclusion criteria. Univariate logistic regression identified pN stage, vascular invasion, and multiple metastatic nodes as risk factors for metastases in levels IV/V. Multivariate analysis found vascular invasion and multiple metastatic nodes were significant. Survival analysis revealed pT, pN, neural infiltration, vascular invasion, number of metastatic nodes, metastases in levels IV/V, and node ratio were significant factors. In multivariate survival analysis, pT, pN, vascular invasion and metastases in levels IV/V were significant. Classificatory analysis showed that pN is non-significant in patients with level IV/V metastases. ConclusionThe occurrence of metastases in levels IV/V was significant for disease-specific survival.
Highlights
Squamous cell carcinomas (SCC) of the oral cavity are categorized in different stages to reflect prognostic factors and determine the most adequate standard course of therapy
The occurrence of metastases in levels IV/V was significant for disease-specific survival
Exclusion criteria: patients with tumors other than SCC as confirmed by histopathology testing, tumors extending to the skin, oropharynx or other sites, patients submitted to previous treatment, primary tumor surgery without neck dissection, patients without metastatic nodes on pathology testing, patients receiving radiotherapy/chemoradiotherapy, and patients with diagnosed systemic metastasis
Summary
Squamous cell carcinomas (SCC) of the oral cavity are categorized in different stages to reflect prognostic factors and determine the most adequate standard course of therapy. Neck lymph nodes are usually the first site affected by metastases in patients with high digestive tract SCC. Neck staging in patients with high digestive tract tumors is standard for most primary tumor sites and is based on the number of metastatic nodes, the size of the largest node, and the side of the involved node in relation to the primary tumor. Depending on the combination of these factors, patients are assigned to one of six stages[3]. This system does not cover all prognostic factors known to be significant, such as the presence of extracapsular tumor extension or lymph node density[4,5]. The staging system’s prognostic role has been criticized due to the limitations it poses mainly in patients submitted to adjuvant therapy, for whom its discriminatory power is significantly diminished[6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
