Contralateral lymph node recurrence rate and its prognostic factors in stage IVA-B well-lateralized oral cavity cancer

Chien, Ju-Chun; Hu, Yongfeng; Chang, Kuo-Chen; Huang, Yu-Hsien; Huang, Chien-Yu; Kang, Bor‐Hwang; Liu, Wen-Shan

doi:10.1016/j.anl.2021.01.016

Cited by 5 publications

(10 citation statements)

References 21 publications

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“…Previous studies have reported an incidence of CLNM in OSCC ranging from 0.9% to 36% ( 9 , 10 , 22 – 24 , 27 – 31 ). Such wide variance seems to be attributable primarily to differences in patient eligibility criteria in terms of anatomic subsites, location, and stage of the tumor, as well as disparity in standard treatment strategies and histopathological processing at each institution.…”

Section: Discussionmentioning

confidence: 99%

“…Although previous studies have not reported independent association between PNI and CLNM, univariate analysis in a previous study showed that the presence of PNI was correlated with a higher risk of CLNM in OSCC patients ( 22 ). In terms of predicting contralateral regional relapse in OSCC, only one multivariate analysis found PNI to be an independent predictor of contralateral lymph node recurrence of stage IV A to IV B, well-lateralized OSCC that excluded TSCC ( 27 ). Another univariate analysis reported significant association between PNI and contralateral regional relapse in OSCC primarily arising from the lateral side of the oral cavities ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

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Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma

Akamatsu

Makino²,

Morita³

et al. 2022

Front. Oncol.

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IntroductionAlthough patients with oral squamous cell carcinoma who develop contralateral neck metastasis (CLNM) have worse survival outcomes than those without CLNM, accurate prediction of occult CLNM in clinically negative contralateral neck (contralateral cN0) remains difficult. This study aimed to identify clinicopathological factors that could reliably predict CLNM in patients with locally advanced (clinical T3 and T4a) tongue squamous cell carcinoma (TSCC).Patients and methodsThe medical data of 32 patients with cT3–4a TSCC who underwent curative surgery between 2010 and 2017 were retrospectively analyzed. The correlation of clinicopathological variables with CLNM was examined using logistic regression analysis. The diagnostic performance of significant variables was evaluated using the area under the receiver operating characteristic curves (AUC). Overall survival (OS) and disease-free survival (DFS) were assessed using a Cox proportional hazards model.ResultsCLNM was eventually confirmed in 11 patients (34.4%). Multivariate logistic regression showed that midline involvement [odds ratio (OR) = 23.10, P = 0.017] and perineural invasion (PNI, OR = 14.96, P = 0.014) were independent predictors of CLNM. Notably, the prediction model comprising a combination of midline involvement and PNI exhibited superior diagnostic performance with an even higher OR of 80.00 (P < 0.001), accuracy of 90.3%, and AUC of 0.876. The multivariate Cox hazards model revealed independent significance of CLNM as an unfavorable prognostic factor for both OS [hazard ratio (HR) = 5.154, P = 0.031] and DFS (HR = 3.359, P = 0.038), as well as that of PNI for OS (HR = 5.623, P = 0.033).ConclusionOur findings suggest that coexisting midline involvement and PNI of the primary tumor is highly predictive of CLNM development, which independently affects both OS and DFS in patients with locally advanced TSCC. Such reliable prediction enables efficient control of CLNM by optimizing management of the contralateral cN0 neck, which will likely contribute to improved prognosis of those patients without unnecessarily compromising their quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma

Akamatsu

Makino²,

Morita³

et al. 2022

Front. Oncol.

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“…Studies have reported results of bilateral neck irradiation in oral cavity cancer with 75-100% cases of diagnosed carcinoma of buccal mucosa [18][19][20]. Contralateral neck treatment rate was 40.8-57%, with 2 of them reporting 5 year DFS of 69-79% and locoregional control of 65-78% [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Lai et al reported contralateral neck failure of 5%. Chien et al, with all patients in stage IV, reported a 3-year DFS of 52.8% and a 3-year contralateral nodal recurrence rate of 15.7% [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of contralateral nodal metastasis in oral cavity cancer varies from 0.9 to 36% [ 24 ]. Studies addressing this issue have tried discovering factors associated with contralateral neck metastasis [ 12 , 20 ]. M Mair et al stated that skin involvement and ipsilateral nodal metastasis are predictors of contralateral neck involvement in carcinoma buccal mucosa [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Pattern of locoregional failure in postoperative cases of locally advanced carcinoma of buccal mucosa treated with unilateral versus bilateral neck radiation: lesson learned from a basic practice setup

Bandyopadhyay

Chhatui

Bagchi

et al. 2022

Rep Pract Oncol Radiother.

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Association of ipsilateral radiation therapy with contralateral lymph node failure in patients with squamous cell carcinoma of the oral cavity: A systematic review and meta‐analysis

et al. 2023

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Background Ipsilateral neck radiotherapy (INRT) is controversial in some patients with oral cavity cancer due to concern for contralateral neck failure (CNF). Methods A systematic review was performed and data were extracted following PRISMA guidelines. Outcomes were the rate of CNF following INRT and the rates of CNF by AJCC 7th ed. tumor and nodal staging. Results Fifteen studies consisting of 1825 patients were identified. Among the 805 patients treated with INRT, the rate of CNF was 5.7%. Patients with T4 tumors constituted 56% of all CNF cases. The rate of CNF increased by N stage (N0: 1.2%; N1: 3.8%; N2‐N3: 17.4%) and was significantly higher for patients with N2‐N3 than N0‐N1 disease (p < 0.001). Discussion INRT is associated with an overall low risk of CNF in well‐selected patients with N0‐N1 disease. Patients with N2‐3 and/or T4 disease should receive bilateral RT due to increased risk of CNF following INRT.

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Contralateral lymph node recurrence rate and its prognostic factors in stage IVA-B well-lateralized oral cavity cancer

Cited by 5 publications

References 21 publications

Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma

Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma

Pattern of locoregional failure in postoperative cases of locally advanced carcinoma of buccal mucosa treated with unilateral versus bilateral neck radiation: lesson learned from a basic practice setup

Association of ipsilateral radiation therapy with contralateral lymph node failure in patients with squamous cell carcinoma of the oral cavity: A systematic review and meta‐analysis

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