Prognostic impact of lingual lymph node metastasis in patients with squamous cell carcinoma of the tongue: a retrospective study

Abstract

Squamous cell carcinoma (SCC) of the tongue rarely metastasizes to the lingual lymph nodes (LLNs), which are inconstant nodes and often situated outside the areas of basic tongue tumor surgery. The current study evaluated the clinicopathological features and prognostic impact of LLN metastasis (LLNM), compared to that of cervical lymph node metastasis, in patients with tongue SCC. A total of 608 patients underwent radical surgery for tongue SCC at our department between January 2001 and December 2016. During neck dissection, we scrutinized and resected lateral LLNs, when present. Of the 128 patients with lymph node metastasis, 107 had cervical lymph node metastasis and 21 had both cervical lymph node metastasis and LLNM. Univariate analysis demonstrated that LLNM was significantly associated with the adverse features of cervical lymph node metastasis. The 5-year disease-specific survival (5y-DSS) was significantly lower in patients with LLNMs than in those without LLNMs (49.0% vs. 88.4%, P < 0.01). Moreover, Cox proportional hazards model analyses revealed that cervical lymph node metastasis at level IV or V and LLNM were independent prognostic factors for 5y-DSS. LLNM has a strong negative impact on survival in patients with tongue SCC. An advanced status of cervical lymph node metastasis may predict LLNM.

Survival Impact of Lingual Lymph Node Metastases in Tongue Cancer: An Analysis Regarding Anatomical Subsites

“…The debate implicates the need for further discussion regarding the anatomical region and the threshold for routine dissection of these rather rare potential metastases. Recently, LLN metastasis has been reported as an independent negative prognostic factor (5)(6)(7)(8); this finding supports the use of the therapeutic strategy of radical resection, known as compartmental resection, proposed by Calabrese et al (9,10).…”

“…Multivariate logistic regression was used to predict LLN metastases based on the following confounding covariates: DOI, nodal metastases, pathological differentiation, and lymphovascular invasion. Each patient was then assigned an estimated propensity score, which was the individual predicted probability of developing LLN metastases (5)(6)(7)(8). Cox regression was also performed by applying propensity scores to adjust for group differences in three alternative ways: 1) regression adjustment; 2) propensity score matching, which paired patients with LLN metastases and others in a 1:1 ratio; and 3) use of the propensity score to create stabilized weights, defined as the inverse probability of treatment weighting (IPTW) (14,15).…”

MicroRNA-18a regulates the metastatic properties of oral squamous cell carcinoma cells via HIF-1α expression

“…Late diagnosis strongly influences the high mortality rate in patients with OSCC [ 4 ]. The presence of lymph node metastasis is one of the critical factors that determine the prognosis in such patients [ 5 , 6 ]. Metastasis is associated with the migration and invasion of cancer cells from the primary tumor and is regulated in multiple steps and by various underlying molecular mechanisms.…”

High expression of Sam68 contributes to metastasis by regulating vimentin expression and a motile phenotype in oral squamous cell carcinoma

“…Despite advances in the diagnosis and treatment of oral squamous cell carcinoma (OSCC), the prognosis of patients with advanced OSCC has not been improved in the past four decades ( 3 ). Metastasis to the cervical lymph nodes is an accurate prognostic factor for patients with OSCC ( 4 – 7 ); however, its molecular mechanism remains unclear. Therefore, there is a need for studies investigating crucial biomarkers and therapeutic targets of metastasis in OSCC.…”