title: Facial lymph node involvement as a prognostic factor for patient survival in oral cavity squamous cell carcinoma.
abstract: To investigate the incidence of metastasis to facial lymph nodes (FLNs) and to determine its impact on the prognosis and survival of patients at onset of oral cavity squamous cell carcinoma (OSCC). A retrospective review of 641 patients with OSCC treated with curative surgery (CS) alone or CS + postoperative radiotherapy (PORT) was performed. Based on FLN status, an analysis of clinicopathologic parameters, prognosis, and survival was conducted. By classifying patients according to FLN status, a reasonable treatment modality was identified in the low-risk group, which was defined as those who had N0-1 disease, negative margin, and no extracapsular nodal spread (ENS). FLN involvement was identified in 103 patients (16 %), which showed statistically significant associations with several established risk factors and negatively affected local controls (P < 0.001), neck controls (P < 0.001), and disease-specific survival (P < 0.001). Compared to CS alone, CS + PORT increased the 5-year neck control rate (76.8 vs. 30.7 %, P = 0.006) and disease-specific survival rate (67.8 vs. 30.7 %, P = 0.037) of the OSCC patients with FLN metastasis in the low-risk group. Metastasis to FLNs is strongly associated with poor disease control and lower survival rate of OSCC patients. PORT minimized the residual risk of involved FLN in the low-risk group.
authors.affiliation: Department of Head & Neck Surgery, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, No. 283, Tongzipo Road, Changsha, 410013, People's Republic of China. 758297696@qq.com.
authors.forename: Li
authors.identifier: http://orcid.org/0000-0002-8675-7623
authors.initials: L
authors.lastname: Xie
authors.affiliation: Department of Head & Neck Surgery, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, No. 283, Tongzipo Road, Changsha, 410013, People's Republic of China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Head & Neck Surgery, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, No. 283, Tongzipo Road, Changsha, 410013, People's Republic of China.
authors.forename: Wenxiao
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Head & Neck Surgery, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, No. 283, Tongzipo Road, Changsha, 410013, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Head & Neck Surgery, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, No. 283, Tongzipo Road, Changsha, 410013, People's Republic of China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Head & Neck Surgery, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, No. 283, Tongzipo Road, Changsha, 410013, People's Republic of China.
authors.forename: Zan
authors.initials: Z
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology; D005145:Face; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies
keywords: Facial lymph node; Neck dissection; Oral squamous cell carcinoma; Postoperative radiotherapy; Surgery