title: The prediction of lymph node metastases from oral squamous carcinoma.
abstract: In an attempt to predict which cases of oral and oropharyngeal squamous carcinoma are likely to metastasize to regional lymph nodes a series of 898 cases was grouped according to site, size, grade of histological differentiation, and presence or absence of histologically confirmed regional lymph node metastases. The results were analysed by a logistic multiple regression analysis. They showed that the sites may be divided into three clusters, Cluster 1 consists of tumors of lip, floor of mouth, cheek mucosa, hard palate, and gingiva. These are not significantly different as regards metastasis rate. Cluster 2 consists of tumors of the anterior two-thirds of tongue and has a higher tendency to metastasis than those in Cluster 1. Lesions of the posterior third of tongue and oropharynx form Cluster 3 which exhibits the greatest tendency to metastasis. Sizes of primary lesions are clustered in groups of lesions less than 3 cm, those 3 to less than 4 cm, and those 4 cm or larger, in ascending tendency to metastasis. Well-differentiated and moderately differentiated tumors are not significantly different in their tendency to metastasize and may be reduced to a single cluster, whereas poorly differentiated tumors have a markedly higher metastasis rate. Using these clusters it has been possible to predict the logistically transformed probability of metastasis to a high degree of accuracy (R=0.9398). From this we conclude that if for a given tumor we know to which site, size or differentiation cluster it belongs, we can then estimate its probability of metastasising.
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005887:Gingival Neoplasms / Q000473:pathology; D006801:Humans; D008048:Lip Neoplasms / Q000473:pathology; D008207:Lymphatic Metastasis; D009062:Mouth Neoplasms / Q000473:pathology*; D010157:Palatal Neoplasms / Q000473:pathology; D011379:Prognosis; D012044:Regression Analysis; D014062:Tongue Neoplasms / Q000473:pathology