title: Evaluation of the level of progression of extracapsular spread for cervical lymph node metastasis in oral squamous cell carcinoma.
abstract: Only a few reports on the level of progression of extracapsular spread (ECS) have been published. The aim of this study was to evaluate the efficacy of the level of progression of ECS in identifying those patients with oral squamous cell carcinoma (OSCC) at a high risk of recurrence who would benefit most from the intensification of adjuvant therapy. The level of progression of ECS for cervical lymph node metastasis in OSCC was divided into three types (A-C), and their relationships with patient prognosis were examined. ECS was observed in 87 of 441 patients with OSCC. The recurrence rate in patients with type C, which was defined as macroscopic tumour invasion into perinodal fat or muscle tissue, was high (69.8%), with 13 cases of death due to distant metastasis. The 3-year disease-specific survival rate for patients with type C was 49.0% and these patients also had a significantly poorer prognosis (P<0.01). The results of the multivariate analysis suggested that the prognosis of ECS in OSCC patients was associated with the level of progression of ECS, especially type C (P<0.01). Overall, the results of this study suggest that the level of progression of ECS is a useful prognostic factor in OSCC patients.
authors.affiliation: Department of Clinical Oral Oncology, Unit of Translational Medicine, Course of Medical and Dental Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Nagano, Japan. Electronic address: shinshin@nagasaki-u.ac.jp.
authors.forename: S
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Clinical Oral Oncology, Unit of Translational Medicine, Course of Medical and Dental Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yanamoto
authors.affiliation: Department of Clinical Oral Oncology, Unit of Translational Medicine, Course of Medical and Dental Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Otani
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Miyakoshi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Minamikawa
authors.affiliation: Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Ohga
authors.affiliation: Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Nagano, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kamata
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Komori
authors.affiliation: Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kitagawa
authors.affiliation: Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Nagano, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kurita
authors.affiliation: Department of Clinical Oral Oncology, Unit of Translational Medicine, Course of Medical and Dental Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Umeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D037981:Neck Dissection; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate
keywords: cervical lymph node metastasis; extracapsular spread; oral squamous cell carcinoma; prognostic factor