Small size of metastatic lymph nodes with extracapsular spread greatly impacts treatment outcomes in oral squamous cell carcinoma patients
Autor: | Yasuyuki Michi, Takuma Morita, Jun Sumino, Chieko Michikawa, Toshiyuki Izumo, Narikazu Uzawa, Yoshio Ohyama |
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Rok vydání: | 2017 |
Předmět: |
Oncology
Male medicine.medical_specialty Metastasis 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine medicine Carcinoma Humans 030223 otorhinolaryngology Prospective cohort study Lymph node Aged Mouth neoplasm Univariate analysis business.industry Middle Aged medicine.disease Prognosis stomatognathic diseases medicine.anatomical_structure Treatment Outcome Otorhinolaryngology 030220 oncology & carcinogenesis Predictive value of tests Lymphatic Metastasis Carcinoma Squamous Cell Surgery Female Mouth Neoplasms Lymph Oral Surgery Neoplasm Recurrence Local business |
Zdroj: | International journal of oral and maxillofacial surgery. 47(7) |
ISSN: | 1399-0020 |
Popis: | Extracapsular spread (ECS) of metastatic lymph nodes from oral carcinoma is the most significant prognostic predictor of a poor treatment outcome. However, only a few reports on prognostic factors in ECS-positive cases have been investigated. To address this problem, a detailed examination of ECS pathology was conducted to determine the prognostic factors of oral squamous cell carcinoma (OSCC) with ECS of metastatic lymph nodes. This study involved 63 OSCC patients with at least one pathologically metastatic node with ECS. Among the 229 metastatic lymph nodes, 149 exhibited ECS. Univariate analysis revealed that a poor outcome and recurrence were significantly associated with the number of ECS-positive nodes, density of ECS, and the minor axis of the smallest ECS-positive node. However, multivariate analysis identified only small size of ECS-positive nodes as a significant and independent factor predicting recurrence and a poor outcome. Thus, small size of ECS-positive nodes is the most important prognostic indicator for OSCC with ECS in metastatic lymph nodes. The classification of ECS status using the minor axis of ECS-positive nodes may be useful for further prediction of a poorer prognosis in OSCC cases. Standardization of ECS diagnosis and multicenter prospective studies will be required to confirm and refine these findings. |
Databáze: | OpenAIRE |
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