Macroscopic and multiple metastases in sentinel lymph node biopsy are respectively associated with poor prognosis in early oral cancer
Macroscopic and multiple metastases in sentinel lymph node biopsy are respectively associated with poor prognosis in early oral cancer
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前哨淋巴结活检中的肉眼可见转移和多发转移分别与早期口腔癌的不良预后相关
DOI：
10.1007/s10147-023-02305-1
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发表时间：
2023
影响因子：
3.3
通讯作者：
Mizumachi Takatsugu
中科院分区：
文献类型：
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作者：
Kondo Takahito;Tsukahara Kiyoaki;Kawakita Daisuke;Yoshimoto Seiichi;Miura Kouki;Sugasawa Masashi;Chikamatsu Kazuaki;Matsuzuka Takashi;Oze Isao;Kitamura Morimasa;Murakami Yoshiko;Otozai Shinji;Shinozaki Takeshi;Ohba Shinichi;Araki Koji;Mizumachi Takatsugu
本研究采用多中心、随机对照的III期临床试验，对T1(Depth of Inflation ≥ 4 mm)-T2N0M0口腔鳞癌患者进行前哨淋巴结活检和择期颈淋巴清扫。本研究在亚组分析的基础上确定了接受SLNB患者预后不良的相关因素。方法我们分析了132名接受SLNB患者的418个前哨淋巴结。根据分离的肿瘤细胞大小将转移的SLN分为三类： <； 0.2 mm；微转移： ≥ 0.2 mm和 <； 2 mm；大转移： ≥ 2 mm。根据转移的SLN数目分为三组：无转移、1个转移结节和2个 ≥ 转移结节。结果大转移和 ≥ 2转移的SLN患者在调整潜在混杂因素后，总体生存率和无瘤生存率均较差(OS的HR为4.85；95%CI为1.34~17.60； ≥ 2转移的SLN为3.6 3；95%CI为1.0 2~12.89；DFS的HR为2.94；95%CI为1.16~7.44； ≥ 2转移的SLN为2.97；95%可信区间为1.18~7.51。结论接受系统性红斑狼疮根治术的患者预后较差，其预后与肿瘤大转移或 ≥ -2转移有关。
BackgroundA multicenter, randomized controlled phase III trial was conducted on sentinel lymph node biopsy (SLNB) and elective neck dissection for T1 (depth of invasion ≥ 4 mm)–T2N0M0 oral cavity squamous cell carcinoma. This study identified factors associated with poor prognosis in patients who underwent SLNB based on a subgroup analysis of this trial.MethodsWe analyzed 418 sentinel lymph nodes (SLNs) from 132 patients who underwent SLNB. The metastatic SLNs were classified into three categories based on size-isolated tumor cells: < 0.2 mm, micrometastasis: ≥ 0.2 mm and < 2 mm, and macrometastasis: ≥ 2 mm. Three groups were formed based on the number of metastatic SLNs: no metastasis, 1 metastatic node, and ≥ 2 metastatic nodes. The size and number of metastatic SLNs on survival were evaluated using Cox proportional hazard models.ResultsPatients with macrometastasis and ≥ 2 metastatic SLNs had worse overall survival (OS) and disease-free survival (DFS) after adjustment for potential confounders (HR for OS: macrometastasis, 4.85; 95% CI 1.34–17.60; ≥ 2 metastatic SLN, 3.63; 95% CI 1.02–12.89; HR for DFS: macrometastasis, 2.94; 95% CI 1.16–7.44; ≥ 2 metastatic SLN, 2.97; 95% CI 1.18–7.51).ConclusionsIn patients who underwent SLNB, a poorer prognosis was associated with macrometastasis or having ≥ 2 metastatic SLNs.