Prediction of cervical lymph node metastasis in squamous cell carcinoma of the tongue/floor of mouth.
BACKGROUND
Cervical lymph node metastasis has a major influence on survival in oral cancer. However, the factors influencing its occurrence are uncertain. Our aim was to improve the prognostic efficiency of the histologic assessment of the primary tumor in predicting metastasis in an individual patient.


METHODS
The relationship between selected clinical and histologic features of the primary tumor of tongue/floor of the mouth and the actual metastatic status was investigated in 45 patients. Invasive cell grading was supplemented by histologic measurements of tumor size and assessments of vascular and perineural invasion.


RESULTS
Ten histologic features showed significant differences in relation to metastasis. A logistic regression model with two predictor variables (total histologic malignancy score and vascular invasion) classified correctly 39 (87%) of the 45 cases.


CONCLUSIONS
Histologic assessment of tumor size and malignancy grade are useful in predicting metastasis. Vascular and perineural invasion are important predictors and should be included in multifactorial malignancy grading schemes. Application of the prognostic index to the biopsy specimen would aid in treatment planning.
Woolgar
J A
JA
Oral Diseases Unit, University of Liverpool School of Dentistry, UK.
Scott
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D004730:Endothelium, Vascular / Q000473:pathology; D005260:Female; D005544:Forecasting; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor / Q000473:pathology* / Q000601:surgery; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery; D009333:Neck; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009474:Neurons / Q000473:pathology; D010347:Patient Care Planning; D011379:Prognosis; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000473:pathology* / Q000601:surgery; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology