title: Lymph node density predicts lung metastases in oral squamous cell carcinoma.
abstract: The association between lymph node density and survival free of lung metastases in oral squamous cell carcinoma (SCC), has not been investigated so far to our knowledge. Lymph node density ≧ 0.07 has been reported by a multicentre international study to be a significant predictor of shorter survival in patients with oral SCC who have invaded nodes. We investigated whether a lymph node density of ≧ 0.07 correlates with shorter overall survival, survival free of distant metastases, and survival free of lung metastases, in patients with oral SCC and invaded lymph nodes. Thirty-five patients with histologically-confirmed invaded lymph nodes werestudied. Their density was calculated as the ratio of the number of invaded lymph nodes:total number of nodes. A density of ≧ 0.07 correlated significantly with shorter overall survival (p<0.02), survival free of distant metastases (p<0.01), and survival free of lung metastases (p<0.01) on log rank testing. On testing by Cox's proportional hazards model of multivariate survival analysis with adjustment for the pathological stage (pstage IV/pstage III), and invaded surgical margins or extracapsular spread, or both, we found that lymph node density ≧ 0.07 was associated with significantly shorter survival (p<0.02). We conclude that lymph node density predicts lung metastases in patients with oral SCC.
authors.affiliation: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Japan. Electronic address: hi.suzuki@aichi-cc.jp.
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Otorhinolaryngology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. Electronic address: ncu.beppin3@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Beppu
authors.affiliation: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Japan. Electronic address: hanai@aichi-cc.jp.
authors.forename: N
authors.initials: N
authors.lastname: Hanai
authors.affiliation: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Japan. Electronic address: hanntagawa@aichi-cc.jp.
authors.forename: H
authors.initials: H
authors.lastname: Hirakawa
authors.affiliation: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Japan. Electronic address: hasegawa@aichi-cc.jp.
authors.forename: Y
authors.initials: Y
authors.lastname: Hasegawa
mesh_terms: D002294:Carcinoma, Squamous Cell; D006801:Humans; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D009062:Mouth Neoplasms; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies
keywords: Lung metastasis; Lymph node density; Oral squamous cell carcinoma