title: Histopathologic predictors of lymph node metastasis and prognosis in tonsillar squamous cell carcinoma.
abstract: BACKGROUND
  Risk factors for lymph node metastasis in tonsillar squamous cell carcinoma (TSCC) need to be established to determine the degree of surgery required to achieve high curative rates. However, little is known currently about the histopathological features predicting prognosis, specifically in TSCC.
  
  
  METHODS
  This study included 53 patients who underwent surgical resection with neck dissection. Clinicopathological factors investigated included age, gender, alcohol use, tobacco consumption, tumor stage, adjacent structure involvement, cell differentiation, squamous dysplasia, in situ carcinoma associated with primary invasive cancer, carcinoma in situ skip lesions, necrosis, invasive front, depth of invasion, and lymphatic, muscle, or perineural invasion.
  
  
  RESULTS
  Contralateral cervical metastasis was associated with higher T stages and soft palate invasion. Lymphatic and muscle invasion were associated with ipsilateral cervical metastasis. Advanced T stage, invasion to the base of tongue, and skip lesions were associated with decreased disease-free survival. Advanced T stage and skip lesions were associated with worse overall survival.
  
  
  CONCLUSIONS
  Advanced T stage and soft palate invasion may predict a high risk of contralateral nodal metastasis. T stage and skip lesion are worse prognostic factors in TSCC and should be commented in pathology reports.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Lee
authors.forename: Mi Jung
authors.initials: MJ
authors.lastname: Kwon
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Nam
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Kwon
authors.forename: Jin Hwan
authors.initials: JH
authors.lastname: Kim
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Rho
authors.forename: Hyung Sik
authors.initials: HS
authors.lastname: Shin
authors.forename: Seong Jin
authors.initials: SJ
authors.lastname: Cho
keywords: Carcinoma, squamous cell; Lymph nodes; Neoplasm metastasis; Palatine tonsil; Prognosis