title: Muscular invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge is associated with cervical lymph node metastasis.
abstract: OBJECTIVE
  To assess the association between muscle invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis on the basis of preoperative magnetic resonance imaging (MRI).
  
  
  METHODS
  Twenty-six patients with oral squamous cell carcinoma of the posterior mandibular alveolar ridge were evaluated by MRI. The associations between cervical lymph node metastasis and independent factors evaluated by MRI were analyzed. Overall survival was also analyzed in this manner. Representative biopsy specimens were stained with anti-podoplanin and anti-CD34 antibodies.
  
  
  RESULTS
  Mylohyoid muscle invasion was associated with cervical lymph node metastasis. A combinational factor of mylohyoid and/or buccinator muscle invasion was also associated with cervical lymph node metastasis. Cervical lymph node metastasis and masticator space invasion had a negative effect on overall survival. No lymphatic vessels were identified near the tumor invasion front within the mandible. In contrast, lymphatic vessels were identified near the front of tumor invasion in the muscles.
  
  
  CONCLUSIONS
  This study demonstrates an association between muscular invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.
authors.forename: Seung-Ki
authors.identifier: 0000-0001-7110-3400
authors.initials: SK
authors.lastname: Min
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.
authors.forename: Hoon
authors.identifier: 0000-0002-9984-8479
authors.initials: H
authors.lastname: Myoung
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.
authors.forename: Jong-Ho
authors.identifier: 0000-0002-8843-545X
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.
authors.forename: Myung-Jin
authors.identifier: 0000-0003-3175-4422
authors.initials: MJ
authors.lastname: Kim
keywords: Cervical lymph node metastasis; Mandibular alveolar ridge; Muscle invasion; Oral squamous cell carcinoma