title: Clinico-pathological factors affecting lymph node yield in Indian patients with locally advanced squamous cell carcinoma of mandibular Gingivo-Buccal sulcus.
abstract: OBJECTIVE
  Lymph node yield (LNY) is a valid marker of prognosis in oral cancer. Precise estimation of LNY in Indian patients with T3/T4 gingivobuccal sulcus squamous cell carcinoma (GBS-SCC) has not been well documented. Hence, the primary objective of the study was to determine the LNY in patients with T3/T4 SCC of mandibular GBS, and the secondary objective was to study the association of LNY with clinicopathological factors such as tumor thickness, histological differentiation, number of positive nodes, and extracapsular spread (ECS).
  
  
  METHODS
  Study patients comprised biopsy proven T3/T4 SCC of mandibular GBS that underwent unilateral surgery (composite or bite composite resection with level I to level V-neck dissection and pectoralis major flap reconstruction) at our center between January 2012 and October 2014. Grossing of surgical specimens was done as per the guidelines established by the Royal College of Pathologists (December 2009). The data were analyzed using SPSS software (22nd version) and Chi-square test.
  
  
  RESULTS
  The surgical specimens of 106 patients yielded 2329 lymph nodes with the mean LNY of 21.97 ± 5.57. Higher mean LNY of over 21 was significantly associated with ECS, number of positive nodes, delay in surgery over 15 days, skin involvement by the tumor, and presence of oral potentially malignant disorders.
  
  
  CONCLUSIONS
  With the single surgeon, pathologist and same surgical procedure, the mean LNY in Indian patients with T3/T4 SCC of mandibular GBS is 21.97 ± 5.57. Although clinicopathological factors affect the estimation of LNY, further studies are needed to validate the findings of this study.
authors.affiliation: Department of Oral and Maxillofacial Surgery, KLE VK Institute of Dental Sciences, KLE University, Belgaum; Department of Surgical Oncology (Head and Neck), Karnataka Cancer Therapy and Research Institute, Hubli, Karnataka, India.
authors.forename: S S
authors.initials: SS
authors.lastname: Muttagi
authors.affiliation: Department of Surgical Oncology, Karnataka Cancer Therapy and Research Institute, Hubli, Karnataka, India.
authors.forename: B R
authors.initials: BR
authors.lastname: Patil
authors.affiliation: Department of Surgery, Jawaharlal Nehru Medical College, KLE University, Belgaum, Karnataka, India.
authors.forename: A S
authors.initials: AS
authors.lastname: Godhi
authors.affiliation: Department of Oral and Maxillofacial Surgery, KLE VK Institute of Dental Sciences, KLE University, Belgaum, Karnataka, India.
authors.forename: D K
authors.initials: DK
authors.lastname: Arora
authors.affiliation: Department of Pathology, KLE VK Institute of Dental Sciences, KLE University, Belgaum, Karnataka, India.
authors.forename: S R
authors.initials: SR
authors.lastname: Hallikerimath
authors.affiliation: Department of Pathology, KLE VK Institute of Dental Sciences, KLE University, Belgaum, Karnataka, India.
authors.forename: A D
authors.initials: AD
authors.lastname: Kale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D007194:India; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008336:Mandibular Diseases / Q000473:pathology*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D011379:Prognosis; D055815:Young Adult