Contralateral Lymph Neck Node Metastasis of Squamous Cell Carcinoma of the Oral Cavity: A Retrospective Analytic Study in 315 Patients

Background: Presence of regional neck node metastasis in head and neck cancer is a major determinant of overall survival. In patients presenting with neck node metastasis, there is a fifty percent decrease in overall survival, irrespective of the treatment modality. Tumor, nodes, metastases staging system, based on the anatomical extent of disease is used to predict patient prognosis and need for adjuvant treatment. Advent of immune based therapy has led to development of new molecular markers which can predict the disease aggressiveness by predicting lymph node and distal metastasis. Epithelial mesenchymal transition (EMT) in cancer is thought to convert the stable epithelial cells to mesenchymal cells that acquire properties of invasion with regional and distal metastasis.Methods: In the current study we evaluated the expression of EMT markers snail and slug in oral squamous cell carcinoma with and without neck node metastasis in 86 patients.Results: In this study, snail positivity was observed in 72 cases (83.72%), slug positivity was observed in 52 cases (60.46%) and either of the two expressions was observed in 77 cases (89.53%). Found that snail was significantly associated with clinical nodal status (p=0.037) and post-op histopathological nodal status (p=0.003). Also found that slug was significantly associated with clinical nodal status (p<0.001), post-op histopathological nodal status (p=0.001) and perineural invasion (p=0.003).Conclusions: Snail and slug positivity correlates with clinical and post-op histopathological nodal status and thus can be used as a predictor of nodal metastasis in oral squamous cell carcinoma.

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Histopathologically Positive Regional Neck Node Metastasis Among Patients with Laryngeal Squamous Cell Carcinoma

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v33i1.27 ◽

2018 ◽

Vol 33 (1) ◽

pp. 30-33

Author(s):

Efren Gerald L. Soliman ◽

Alfredo Quintin Y. Pontejos

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Neck Dissection ◽

Squamous Cell ◽

Laryngeal Squamous Cell Carcinoma ◽

Clinical Stage ◽

Fisher Exact Test ◽

Neck Node ◽

Node Metastasis ◽

Neck Node Metastasis

Objective: To determine the patterns of regional neck node metastasis in laryngeal squamous cell carcinoma in Filipinos according to subsite and clinical stage, and to determine possible factors associated with level V involvement. Methods: Design: Retrospective Case Series Setting: Tertiary National University Hospital Participants: A chart review was conducted for patients diagnosed with laryngeal squamous cell carcinoma who underwent laryngectomy with neck dissection from January 2011 to April 2015. Medical information obtained included demographics, clinical parameters, and histopathologic reports of nodal involvement. The rate and location of positive neck nodes was recorded according to clinical stage and primary subsite. Fisher exact test was used to determine significant risk factors for level V cervical lymph node involvement. Results: Of 56 patients included, most were male with an average age of 61 years. Most patients had cancer originating from the glottic subsite, with the majority being staged III and IVA according to the TNM classification. Histopathologically positive neck nodes were centered at levels II to IV. No significant association was seen between level V involvement and the studied clinicopathologic factors (age, sex, tumor differentiation, subsite involvement, involvement of other neck node levels). Conclusion: Cervical neck node levels II, III, and IV are the most commonly involved in neck dissection, with many being positive for nodal metastasis for these levels. Level V nodes may be removed when clinically positive, but elective neck dissection may exclude this level. The current practice of neck dissection appears to be appropriate in terms of selecting the most likely locations of metastatic spread. Further study is recommended, with a greater population and standardized levels of neck dissection. Keywords: laryngeal cancer, lymphatic metastasis, neck dissection, squamous cell carcinoma

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Laryngeal malignancy: relation of tumor size and neck node metastasis

Nepal Journal of Medical Sciences ◽

10.3126/njms.v2i1.7652 ◽

2013 ◽

Vol 2 (1) ◽

pp. 48-51 ◽

Cited By ~ 1

Author(s):

K Koirala ◽

V Sharma

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Tumor Size ◽

Primary Tumor ◽

Laryngeal Squamous Cell Carcinoma ◽

Neck Node ◽

Prognostic Features ◽

Node Metastasis ◽

Neck Node Metastasis

Background: Laryngeal malignancy is a common pathological entity. Size of the primary tumor and neck node metastasis both are bad prognostic features. Purpose of this retrospective study is to see if the tumor size of primary laryngeal squamous cell carcinoma correlates with the neck node metastasis. Methods: Patients of all ages and both sex with biopsy proven squamous cell carcinoma of larynx were included in the study. After detailed history taking and clinical examination to identify the size of the primary tumor and neck node metastasis, biopsy was taken from the primary site under general anesthesia. Fine Needle Aspiration Cytology (FNAC) of the palpable neck node(s) was also performed. Data were analyzed using SPSS software for windows. Results: Fifty seven new cases of laryngeal squamous cell carcinoma with mean age of 72.71 were included in the study. Supra glottic layrnx was the most common site affected. Neck node metastasis was more frequent in tumor of bigger size (higher T stage) and the difference was statistically significant (p=0.001). Conclusion: The size of primary laryngeal squamous cell carcinoma correlates with the neck node metastasis. This information can be used for the therapeutic implementation as well. Nepal Journal of Medical Sciences | Volume 02 | Number 01 | Jan-Jun 2013 | Page 48-51 DOI: http://dx.doi.org/10.3126/njms.v2i1.7652

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Clinical significance of neck node metastasis in squamous cell carcinoma of the maxillary antrum

American Journal of Otolaryngology ◽

10.1016/s0196-0709(99)90078-9 ◽

1999 ◽

Vol 20 (6) ◽

pp. 383-390 ◽

Cited By ~ 45

Author(s):

Gwi Eon Kim ◽

Eun Ji Chung ◽

John Jihoon Lim ◽

Ki Chang Keum ◽

Sang Wook Lee ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Clinical Significance ◽

Squamous Cell ◽

Maxillary Antrum ◽

Neck Node ◽

Node Metastasis ◽

Neck Node Metastasis

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Relation between the depth of tumor and neck node metastasis in early carcinoma of tongue

International Surgery Journal ◽

10.18203/2349-2902.isj20182081 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2154

Author(s):

Pankaj Kshirsagar ◽

Kshitij Arun Manerikar

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Sensitivity And Specificity ◽

Squamous Cell ◽

Primary Tumor ◽

Neck Node ◽

Node Metastasis ◽

Cervical Node ◽

Neck Node Metastasis ◽

Carcinoma Of Tongue

Background: Tongue squamous cell carcinoma (TSCC) is one of the aggressive forms of oral cancer with a high recurrence rate. Forty percentages of all TSCC patients have neck metastasis at the time of diagnosis. The status of cervical lymph nodes at presentation is the single most important prognostic factor in TSCC. This study was focused on establishing relation between the tumor depth and neck node metastasis in carcinoma of tongue. Authors accessed the patterns of cervical node metastasis in it.Methods: prospective non-randomised study of 100 patients was carried out. After detail clinical history punch biopsy were taken from the tongue lesion. Biopsy proven cases of early squamous cell carcinoma (T1/T2) with clinically negative neck (cN0) were included in this study. Ultra-sonography of the tongue using 7.5 MHz probe was performed in all cases to know the depth of lesion. Final histopathological findings i.e. pT, pN, differentiation and depth of invasion were compared with pre-operative clinical and radiological findings.Results: Out of 100 patients, 62 were males and 38 were females. Clinically 56 patients were belonged to T2. Ultra-sonography of tumor had high sensitivity and specificity. Node positivity increased with the depth of primary tumor. On histopathological examination, positive node observed in total 25 patients. Number of occult neck node positivity raised with increased size of primary tumor. i.e. 15% and 31% with pT1 and pT2, respectively. Level II was the most common site for cervical node involvement followed by level III.Conclusions: Ultra-sonography was a reliable tool to access the depth of tumor pre-operatively in the cases of tongue carcinoma patients with sensitivity and specificity more than 90%. Node positivity increased with the depth of primary tumor. Tumor thickness is a significant predictor of nodal metastasis and elective neck dissection should be decided accordingly.

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The Effects of Tumor Size, Degree of Differentiation, and Depth of Invasion on the risk of Neck Node Metastasis in Squamous Cell carcinoma of the Oral Cavity

Ear Nose & Throat Journal ◽

10.1177/014556131209100311 ◽

2012 ◽

Vol 91 (3) ◽

pp. 130-135 ◽

Cited By ~ 12

Author(s):

Mehmet Haksever ◽

Hasan Mete İnançlí ◽

Ümit Tunçel ◽

Şefik Sinan Kürkçüoğlu ◽

Melek Uyar ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Cell Carcinoma ◽

Squamous Cell ◽

Tumor Size ◽

Depth Of Invasion ◽

Neck Node ◽

Node Metastasis ◽

Neck Node Metastasis ◽

Degree Of Differentiation

Cervical lymph node metastasis is the most important prognostic factor in patients with head and neck carcinoma. We retrospectively analyzed the effects of three different variables—tumor size, degree of differentiation, and depth of invasion—on the risk of neck node metastasis in 50 adults who had been treated with surgery for primary squamous cell carcinoma of the oral cavity. Primary tumor depth and other pathologic features were determined by reviewing the pathology specimens. Preoperatively, 36 of the 50 patients were clinically N0; however, occult lymph node metastasis was found in 13 of these patients (36.1%). The prevalence of neck node metastasis in patients with T1/T2 and T3/T4 category tumors was 51.5 and 58.8%, respectively. The associations between the prevalence of neck node metastasis and both the degree of differentiation and the depth of invasion were statistically significant, but there was no significant association between neck node metastasis and tumor size. We conclude that the prevalence of neck lymph node metastasis inpatients with squamous cell carcinoma of the oral cavity increases as the tumor depth increases and as the degree of tumor differentiation decreases from well to poor, as has been shown in previous studies. It is interesting that tumor size, which is the most important component of the TNM system, was not significantly associated with neck node involvement.

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