title: Lymph node metastasis of early oral tongue cancer after interstitial radiotherapy.
abstract: OBJECTIVE
  To examine the prognostic factors for lymph node metastasis after brachytherapy for early (T1-T2N0M0) oral tongue cancer.
  
  
  METHODS
  We reviewed the records of 571 patients (500 low dose rate and 71 high dose rate) treated at Osaka University Hospital between 1967 and 1999.
  
  
  RESULTS
  Patients with lymph node metastasis had tumor with an average diameter of 26 +/- 8 mm and a thickness of 9 +/- 5 mm; for patients without lymph node metastasis, the corresponding dimensions were 23 +/- 8 mm and 7.5 +/- 4 mm (p = 0.0004 and 0.001, respectively). After 5 years, the ulcerative (48%) and indurative/infiltrative (39%) types showed a higher ratio of nodal involvement than the exophytic (31%) and superficial (19%) types (p <0.0001). Multivariate analysis showed ulceration (p = 0.006) and a thickness of <or =6 mm (p = 0.04) to be statistically significant predisposing factors for lymph node metastasis. The lymph node control rate was 68% in 1967-1979, 71% in 1980-1990, and 66% in 1990-1999; the corresponding successful salvage rates for lymph node metastasis were 43%, 33%, and 58% (p = 0.04).
  
  
  CONCLUSIONS
  The appearance of the tumor, especially the presence or absence of ulceration and the diameter and thickness, are useful prognostic indicators for lymph node metastasis. Although the rates of lymph node metastasis did not change, the salvage outcome for recurrence after interstitial radiotherapy has recently improved.
authors.affiliation: Department of Radiology, Toyonaka Municipal Hospital, Toyonaka City, Osaka, Japan. hideya10@hotmail.com
authors.forename: Hideya
authors.initials: H
authors.lastname: Yamazaki
authors.forename: Takehiro
authors.initials: T
authors.lastname: Inoue
authors.forename: Ken
authors.initials: K
authors.lastname: Yoshida
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tanaka
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yoshioka
authors.forename: Hironobu
authors.initials: H
authors.lastname: Nakamura
authors.forename: Souhei
authors.initials: S
authors.lastname: Furukawa
authors.forename: Kimishige
authors.initials: K
authors.lastname: Shimizutani
authors.forename: Naoya
authors.initials: N
authors.lastname: Kakimoto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009333:Neck; D009367:Neoplasm Staging; D016879:Salvage Therapy; D014062:Tongue Neoplasms / Q000473:pathology* / Q000532:radiotherapy