Risk factors for late cervical lymph node metastases in patients with stage I or II carcinoma of the tongue

Hideo Kurokawa, Yoshihiro Yamashita, Shinobu Takeda, Min Zhang, Hiroshi Fukuyama, Tetsu Takahashi

Research output: Contribution to journalArticle

166 Citations (Scopus)

Abstract

Background. Many histopathologic parameters in squamous cell carcinoma of the tongue have been identified as predictive factors for cervical lymph metastasis. However, predictive factors for occult cervical lymph node metastases and the criterion for elective therapy remain inconclusive. This study analyzed the clinicopathologic factors associated with late cervical lymph node metastases in patients with carcinoma of the tongue. Methods. The clinicopathologic features of 50 consecutive patients seen between January 1985-December 1996 with previously untreated stage I or II squamous cell carcinoma of the tongue were reviewed. All patients were treated with partial glossectomy without elective neck dissection. Their mean age was 54.5 y (range, 23-90 y) and the male-female ratio was 1.2:1 (27 men and 23 women); 30 cases were stage I, and 20 cases were stage II. Clinicopathologic factors were analyzed to determine factors predicting late cervical lymph node metastasis. Results. The overall cervical lymph node metastasis rate was 14.0% (7 of 50). Clinicopathologic factors significantly associated with the development of cervical lymph node metastasis were tumor size (≥30 mm), tumor depth (≥4 mm), differentiation, mode of invasion, microvascular invasion, and histologic grade of malignancy. In a multivariate logistic regression analysis, moderately differentiated squamous cell carcinoma of the tongue with tumor depth ≥4 mm had predictive value for late cervical lymph node metastasis and diminished overall survival (odds ratio, 10.0; p = .02; hazards ratio, 7.0; p = .039). Conclusions. The findings of this study demonstrate tumor depth ≥4 mm moderately differentiated squamous cell carcinoma of the tongue have a substantially higher rate of late cervical metastases. In the basis of these data, it is our recommendation that this be used in the decision to electively treat the neck.

Original languageEnglish
Pages (from-to)731-736
Number of pages6
JournalHead and Neck
Volume24
Issue number8
DOIs
Publication statusPublished - 2002 Aug 19
Externally publishedYes

Keywords

  • Cervical lymph node metastasis
  • Elective neck treatment
  • Oral squamous cell carcinoma
  • Tumor depth

ASJC Scopus subject areas

  • Otorhinolaryngology

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