title: Oral cavity squamous cell carcinoma: factors related to occult lymph node metastasis.
abstract: BACKGROUND
  Elective neck dissection is recommended in cases of oral cavity squamous cell carcinoma without lymph node metastasis because of the risk of occult metastasis.
  
  
  OBJECTIVE
  The present study aimed to evaluate predictive factors for occult lymph node metastasis in patients with oral cavity squamous cell carcinoma treated with elective neck dissection and their impact on overall and disease-free survival.
  
  
  METHODS
  Forty surgically treated patients were retrospectively included.
  
  
  RESULTS
  Ten cases (25%) had lymphatic metastasis. Of the studied variables, perineural and angiolymphatic invasion in addition to tumor thickness were statistically associated with lymph node metastasis. Only angiolymphatic invasion was identified as an independent risk factor for occult metastasis in the logistic regression (OR=39.3; p=0.002). There was no association between overall and disease-free survival with the presence of occult lymph node metastasis.
  
  
  CONCLUSIONS
  Metastatic disease rate was similar to that found in the literature. Perineural and angiolymphatic invasion and tumor thickness were associated with occult metastasis, but only angiolymphatic invasion showed to be an independent risk factor.
authors.affiliation: Discipline of Head and Neck Surgery, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
authors.forename: André Fernandes
authors.initials: AF
authors.lastname: d'Alessandro
authors.affiliation: Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil.
authors.forename: Fábio Roberto
authors.initials: FR
authors.lastname: Pinto
authors.affiliation: Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil.
authors.forename: Chin Shien
authors.initials: CS
authors.lastname: Lin
authors.affiliation: Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil.
authors.forename: Marco Aurélio Vamondes
authors.initials: MA
authors.lastname: Kulcsar
authors.affiliation: Discipline of Head and Neck Surgery, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
authors.forename: Cláudio Roberto
authors.initials: CR
authors.lastname: Cernea
authors.affiliation: Discipline of Head and Neck Surgery, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
authors.forename: Lenine Garcia
authors.initials: LG
authors.lastname: Brandão
authors.affiliation: Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil. Electronic address: lmatos@amcham.com.br.
authors.forename: Leandro Luongo de
authors.initials: LL
authors.lastname: Matos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017558:Elective Surgical Procedures; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods*; D009367:Neoplasm Staging; D015996:Survival Rate
keywords: Boca; Carcinoma; Células escamosas; Lymphatic metastasis; Metástase linfática; Mouth; Prognosis; Prognóstico; Squamous cell