Risk factors for late cervical lymph node metastases in patients with stage I or II carcinoma of the tongue
Risk factors for late cervical lymph node metastases in patients with stage I or II carcinoma of the tongue
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DOI：
10.1002/hed.10130
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发表时间：
2002-08-01
影响因子：
2.9
通讯作者：
Takahashi, T
中科院分区：
文献类型：
--
作者：
Kurokawa, H;Yamashita, Y;Takahashi, T
背景。舌鳞状细胞癌的许多组织病理学参数已被确定为颈部淋巴转移的预测因素。然而，隐匿性颈部淋巴结转移的预测因素和选择性治疗的标准仍然没有定论。本研究分析了舌癌患者晚期颈部淋巴结转移的临床病理因素。方法。对 1985 年 1 月至 1996 年 12 月期间连续观察到的 50 名先前未经治疗的 I 期或 11 期舌鳞状细胞癌患者的临床病理特征进行了回顾。所有患者均接受部分舌切除术，没有选择性颈清扫术。他们的平均年龄为 54.5 岁（范围为 23-90 岁），男女比例为 1.21（男性 27 名，女性 23 名）； Ⅰ期30例，Ⅱ期20例。分析临床病理因素以确定预测晚期颈部淋巴结转移的因素。结果。总体颈部淋巴结转移率为14.0%（50例中有7例）。与颈部淋巴结转移显着相关的临床病理因素包括肿瘤大小（大于或等于30 mm）、肿瘤深度（A mm）、分化程度、侵袭方式、微血管侵犯和恶性组织学分级。在多变量 Logistic 回归分析中，肿瘤深度大于或等于 4 mm 的中分化舌鳞状细胞癌对晚期颈部淋巴结转移具有预测价值，并降低总生存率（比值比，10.0；p = .02；风险比，7.0；p = .039）。结论。这项研究的结果表明，肿瘤深度为A毫米的中分化舌鳞状细胞癌的晚期宫颈转移率要高得多。根据这些数据，我们建议将其用于选择性治疗颈部的决定。 (C) 2002 年 Wiley 期刊公司
Background. Many histopathologic parameters in squamous cell carcinoma of the tongue have been identified as predictive factors for cervical lymph metastasis. However, predictive factors for occult cervical lymph node metastases and the criterion for elective therapy remain inconclusive. This study analyzed the clinicopathologic factors associated with late cervical lymph node metastases in patients with carcinoma of the tongue.Methods. The clinicopathologic features of 50 consecutive patients seen between January 1985-December 1996 with previously untreated stage I or 11 squamous cell carcinoma of the tongue were reviewed. All patients were treated with partial glossectomy without elective neck dissection. Their mean age was 54.5 y (range, 23-90 y) and the male-female ratio was 1.21 (27 men and 23 women); 30 cases were stage I, and 20 cases were stage II. Clinicopathologic factors were analyzed to determine factors predicting late cervical lymph node metastasis.Results. The overall cervical lymph node metastasis rate was 14.0% (7 of 50). Clinicopathologic factors significantly associated with the development of cervical lymph node metastasis were tumor size (greater than or equal to30 mm), tumor depth ( A mm), differentiation, mode of invasion, microvascular invasion, and histologic grade of malignancy. In a multivariate logistic regression analysis, moderately differentiated squamous cell carcinoma of the tongue with tumor depth greater than or equal to4 mm had predictive value for late cervical lymph node metastasis and diminished overall survival (odds ratio, 10.0; p = .02; hazards ratio, 7.0; p = .039).Conclusions. The findings of this study demonstrate tumor depth A mm moderately differentiated squamous cell carcinoma of the tongue have a substantially higher rate of late cervical metastases. In the basis of these data, it is our recommendation that this be used in the decision to electively treat the neck. (C) 2002 Wiley Periodicals, Inc.