Risk factors for late cervical lymph node metastases in patients with stage I or II carcinoma of the tongue.
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 II 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 1.2:1 (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 (> or =30 mm), tumor depth (> or =4 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 > or =4 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 > or =4 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.
Second Department of Oral and Maxillofacial Surgery, Kyushu Dental College, 2-6-1 Manazuru, Kitakyushu City, 803-8580, Japan. kuro@kyu-dent.ac.jp
Hideo
H
Kurokawa
Yoshihiro
Y
Yamashita
Shinobu
S
Takeda
Min
M
Zhang
Hiroshi
H
Fukuyama
Tetsu
T
Takahashi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000473:pathology* / Q000601:surgery