Neck lymphatic metastasis, surgical methods and prognosis in early tongue squamous cell carcinoma
10.3760/cma.j.issn.1002-0098.2018.02.001
- VernacularTitle: 早期舌鳞状细胞癌颈淋巴结转移规律、手术方式选择及预后相关因素分析
- Author:
Lishan WANG
1
;
Futing ZHOU
1
;
Chengbing HAN
1
;
Xiaopo HE
1
;
Zuxun ZHANG
1
Author Information
1. Department of Oral and Maxillofacial Surgery, Weifang People's Hospital, Weifang Shandong 261000, China
- Publication Type:Journal Article
- Keywords:
Neck dissection;
Prognosis;
Carcinoma, squamous cell;
Tongue neoplasms
- From:Chinese Journal of Stomatology
2018;53(2):73-78
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the different pattern of neck lymph node metastasis, the choice of surgical methods and prognosis in early tongue squamous cell carcinoma.
Methods:A total of 157 patients with early oral tongue squamous cell carcinoma were included in this study. Statistical analysis was performed to identify the pattern of lymph node metastasis, to determine the best surgical procedure and to analyze the prognosis.
Results:The occurrence of cervical lymph node metastasis rate was 31%(48/157). Neck lymphatic metastasis was significantly related to tumor size (P=0.026) and histology differentiation type (P=0.022). The rate of metastasis was highest in level Ⅱ [33% (16/48)]. In level Ⅳ, the incidence of lymph node metastasis was 5%(7/157), and there was no skip metastases. The possibility of level Ⅳ metastasis was higher, when level Ⅱ (P=0.000) or Ⅲ (P=0.000) involved. The differentiation tumor recurrence, neck lymphatic metastasis and adjuvant radiotherapy were prognostic factors (P<0.05). Multivariate analyses revealed histology differentiation type, neck lymphatic metastases and adjuvant radiotherapy were the independent prognostic factors.
Conclusions:Neck lymphatic metastasis rate is high in early tongue squamous cell carcinoma, simultaneous glossectomy and neck dissection should be performed. Level Ⅳ metastasis rate is extremely low, so supraomohyoid neck dissection is sufficient for most of the time. The histology differentiation type, neck lymphatic metastasis and adjuvant radiotherapy are independent prognostic factors.
