Oral cavity squamous cell carcinoma: factors related to occult lymph node metastasis

INTRODUCTION: Elective neck dissection is recommended in cases of oral cavity squamous cell carcinoma without lymph node metastasis because of the risk of occult metastasis. OBJECTIVE: The present study aimed to evaluate predictive factors for occult lymph node metastasis in patients with oral cavity squamous cell carcinoma treated with elective neck dissection and their impact on overall and disease-free survival. METHODS: Forty surgically treated patients were retrospectively included. RESULTS: Ten cases (25%) had lymphatic metastasis. Of the studied variables, perineural and angiolymphatic invasion in addition to tumor thickness were statistically associated with lymph node metastasis. Only angiolymphatic invasion was identified as an independent risk factor for occult metastasis in the logistic regression (OR = 39.3; p = 0.002). There was no association between overall and disease-free survival with the presence of occult lymph node metastasis. CONCLUSION: Metastatic disease rate was similar to that found in the literature. Perineural and angiolymphatic invasion and tumor thickness were associated with occult metastasis, but only angiolymphatic invasion showed to be an independent risk factor

引言：口腔鳞状细胞癌（Oral Cavity Squamous Cell Carcinoma）无淋巴结转移者，因存在隐匿性转移风险，推荐行择区性颈清扫术（Elective Neck Dissection）。研究目的：本研究旨在评估接受择区性颈清扫术的口腔鳞状细胞癌患者隐匿性淋巴结转移的预测因素，及其对总生存期（Overall Survival）与无病生存期（Disease-Free Survival）的影响。研究方法：本研究回顾性纳入了40例接受手术治疗的患者。研究结果：10例（25%）存在淋巴结转移。在所分析的变量中，肿瘤厚度、神经周围浸润与血管淋巴管浸润均与淋巴结转移具有统计学相关性。经Logistic回归分析，仅血管淋巴管浸润被确定为隐匿性转移的独立危险因素（比值比（Odds Ratio）=39.3；P=0.002）。隐匿性淋巴结转移与总生存期及无病生存期无显著关联。结论：本研究的转移发生率与现有文献报道结果相近。神经周围浸润、血管淋巴管浸润及肿瘤厚度均与隐匿性转移相关，但仅血管淋巴管浸润被证实为独立危险因素。