title: Cervical metastases behavior of T1-2 squamous cell cancer of the oral mucosa.
abstract: OBJECTIVE
  The clinical management of the neck of patients with early-stage oral squamous cell cancer (OSCC) is still controversially discussed in the current literature. This study analyzes histo-clinical factors influencing the occurrence of cervical lymph node metastases (CM).
  
  
  METHODS
  In a retrospective mono-center study, patients with a primary T1-2 OSCC between 2000 and 2014 were analyzed regarding histo-clinical parameters possibly influencing the CM rate and the outcome.
  
  
  RESULTS
  Two hundred eighty-five patients (66 %) were male and 146 female (44 %), with a mean age of 60 ± 12 years at the time of diagnosis. Seventy-seven percent showed a positive risk profile (nicotine/alcohol) and 69 % underlying diseases. Forty-four percent of the patients were staged as T2 (30 % with CM). Advanced tumor size (T1 vs. T2) and grading (G1-2 vs. G3) were statistically significantly (p < 0.001) associated with the occurrence of CM. The localization within the oral cavity, age, gender, risk profile, or underlying diseases had no influence on CM occurrence. During the follow-up, tumor size (p = 0.001), CM (p < 0.001), and tumor relapse (p < 0.001) were significantly associated with a worse outcome.
  
  
  CONCLUSIONS
  Early-stage OSCC showed aggressive lymphatic metastatic behavior that depends on the size and the grading of the tumor.
  
  
  CONCLUSIONS
  A watch-and-wait policy as the primary management for cN0 may likely be inferior to a selective neck dissection for this patient group and should only be considered for very small tumors with a good differentiation.
authors.affiliation: Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany. keyvan.sagheb@unimedizin-mainz.de.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Sagheb
authors.affiliation: Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Blatt
authors.affiliation: Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
authors.forename: Roman-Kia
authors.initials: RK
authors.lastname: Rahimi-Nedjat
authors.affiliation: Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Eigenbrodt
authors.affiliation: Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
authors.forename: Bilal
authors.initials: B
authors.lastname: Al-Nawas
authors.affiliation: Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Walter
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000473:pathology*; D037981:Neck Dissection; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Head and neck cancer; Lymphatic metastasis; Oral cancer; Oral squamous cell carcinoma