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

André Fernandes d'Alessandro, Fábio Roberto Pinto, Chin Shien Lin, Marco Aurélio Vamondes Kulcsar, Cláudio Roberto Cernea, Lenine Garcia Brandão, Leandro Luongo de Matos, André Fernandes d'Alessandro, Fábio Roberto Pinto, Chin Shien Lin, Marco Aurélio Vamondes Kulcsar, Cláudio Roberto Cernea, Lenine Garcia Brandão, Leandro Luongo de Matos

Abstract

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.

Keywords: Boca; Carcinoma; Células escamosas; Lymphatic metastasis; Metástase linfática; Mouth; Prognosis; Prognóstico; Squamous cell.

Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Figures

Figure 1
Figure 1
Kaplan–Meier Curves. (A) Cumulative disease-free survival of 68.2%; (B) Cumulative overall survival of 64.1%.
Figure 2
Figure 2
Kaplan–Meier curves comparing the groups with absence and presence of occult lymph node metastasis. (A) Cumulative disease-free survival of 71.4% and 60.0%, respectively, for the absence and presence of occult lymph node metastases (p = 0.587 – log-rank test); (B) Cumulative overall survival of 80.4% and 40.0%, respectively, for the absence and presence of occult lymph node metastases (p = 0.248 – log-rank test).

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