The density of metastatic lymph node as prognostic factor in squamous cell carcinoma of the tongue and floor of the mouth.
The presence of metastatic lymph nodes is a relevant prognostic factor in oral cancer.


OBJECTIVE
This paper aims to assess metastatic lymph node density (pN+) in patients with tongue and floor-of-mouth squamous cell carcinoma (SCC) and the association of this parameter with disease-free survival (DFS).


METHODS
A group of 182 patients seen between 1985 and 2007 was included, 169 of which were males. Five were on stage I, 35 on stage II, 56 on stage III, and 85 on stage IV. Median values were considered in lymph node density assessment, and the Kaplan-Meier curve was used to evaluate DFS; survival differences within the group were elicited through the log-rank test.


RESULTS
An average 3.2 metastatic lymph nodes were excised from the patients in the group. Density ranged from 0.009 to 0.4, with a mean value of 0.09. Five-year DFS rates were of 44% and 28% for the groups with lymph node densities below and above the median respectively (p = 0.006). Two-year local/regional control was achieved for 71% and 49% for the patients below and above the median density respectively (p = 0.01). In terms of pN staging, local/regional control was achieved in 70% and 54% of pN1 and pN2 patients respectively, albeit without statistical significance (0.20%).


CONCLUSIONS
Lymph node density may be used as a prognostic indicator for tongue and floor-of-mouth SCC.
Department of Otorhinolaryngology and Head & Neck Surgery at the Heliópolis Hospital, São Paulo, SP, Brazil.
Ali
A
Amar
Abrão
A
Rapoport
Otávio Alberto
OA
Curioni
Rogério Aparecido
RA
Dedivitis
Cláudio Roberto
CR
Cernea
Lenine Garcia
LG
Brandão
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor / Q000473:pathology; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery; D037981:Neck Dissection; D009367:Neoplasm Staging; D011379:Prognosis; D012008:Recurrence; D014062:Tongue Neoplasms / Q000473:pathology / Q000601:surgery; D055815:Young Adult