title: Oral squamous cell carcinoma with multiple neck metastases--cases with more than ten pathologically positive lymph nodes in the unilateral side.
abstract: OBJECTIVE
  The purpose of this study is to know an outcome of the treatment for oral squamous cell carcinoma having more than 10 unilateral pathologically positive lymph nodes (pN)s.
  
  
  METHODS
  We reviewed 212 primary cases of oral squamous cell carcinoma that visited our hospital from January 1999 to December 2011 and underwent resection of the primary tumor with neck dissection. The patients were classified into 3 categories of pN0, pN1-9, and pN ≥ 10 cases, and an outcome of pN ≥ 10 was studied specifically in comparison with the other categories.
  
  
  RESULTS
  Of the patients studied, 103 cases (48.6%) were pN0, 103 cases (48.6%) were pN1-9, and 6 cases (2.8%) were pN ≥ 10. The pN ≥ 10 group, which had positive nodes of 10 to 30 on the ipsilateral side, was predominantly male and had no cases of well-differentiated squamous cell carcinoma. Extracapsular spread (ECS) was found in all pN ≥ 10 cases, and postoperative distant metastasis occurred in cases with ECS, which was localized in levels higher than III. The proportion of distant metastasis was 0% (0 cases) in pN0, 8.7% (9 cases) in pN1-9, and 66.7% (4 cases) in pN10. Overall survival rate in pN ≥ 10 was 20.8%, whereas it was 89.0% in pN0, and 34.9% in pN1-9.
  
  
  CONCLUSIONS
  Oral squamous cell carcinoma having multiple neck metastases (pN ≥ 10) had a poor prognosis because the proportion of distant metastasis was higher in comparison with the other groups of pN0 and pN1-9.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. shibuya@med.kobe-u.ac.jp
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Shibuya
authors.forename: Takumi
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Masaya
authors.initials: M
authors.lastname: Akashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Shigeta
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Minamikawa
authors.forename: Takahide
authors.initials: T
authors.lastname: Komori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D005887:Gingival Neoplasms / Q000473:pathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor / Q000473:pathology; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery; D009333:Neck; D037981:Neck Dissection; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000473:pathology