Patterns of lymph node involvement for oral cavity squamous cell carcinoma.

Ludwig, Roman; Werlen, Sandrine; Barbatei, Dorothea; Widmer, Lars; Pouymayou, Bertrand; Balermpas, Panagiotis; Elicin, Olgun; Dettmer, Matthias; Zrounba, Philippe; Giger, Roland; Grégoire, Vincent; Schubert, Adrian; Unkelbach, Jan (2024). Patterns of lymph node involvement for oral cavity squamous cell carcinoma. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 200, p. 110474. Elsevier Scientific Publ. Ireland 10.1016/j.radonc.2024.110474

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AIM

Whereas the prevalence of lymph node level (LNL) involvement in oral cavity squamous cell carcinomas (OCSCC) has been reported, the details of lymphatic progression patterns are insufficiently quantified. We investigate how the risk of metastases in each LNL depends on the involvement of adjacent LNLs, T-category, subsite, primary tumor lateralization, and other risk factors.

METHODS

We retrospectively analyzed patients with newly diagnosed OCSCC from two institutions, totaling 348 patients. Involvement of LNLs I-V was recorded individually based on pathology after neck dissection with clinicopathological factors. The dataset is publicly available in a previously developed web-app, which allows querying patients with specific combinations of co-involved LNLs and tumor characteristics.

RESULTS

Ipsilateral involvement prevalence of levels I-III was higher for advanced T-category (T3/T4) patients (32 %, 38 %, 14 %) compared to early (T1/T2) patients (14 %, 23 %, 11 %). Involvement of level I increased the involvement probability in levels II and III. Similarly, involvement of level II increased the involvement probability in levels I and III. However, there was significant isolated involvement of level I or II. Advanced nodal involvement (>1 LNL involved) was more frequent for patients with extracapsular extension. Overall contralateral involvement in levels I-III was 7 %, 4 %, 3 % and more frequent for more advanced ipsilateral involvement and for midline-crossing tumors. Involvement of levels IV and V was rare: 3 % ipsilateral and 1 % contralateral in both levels.

CONCLUSIONS

Detailed quantification of LNL involvement in OCSCC depending on involvement of adjacent LNLs and clinicopathological factors may allow further personalizing guidelines on elective nodal treatment.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT) 04 Faculty of Medicine > Service Sector > Institute of Pathology 04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology
UniBE Contributor:	Eliçin, Olgun, Dettmer, Matthias, Giger, Roland, Schubert, Adrian
Subjects:	600 Technology > 610 Medicine & health 500 Science > 570 Life sciences; biology
ISSN:	1879-0887
Publisher:	Elsevier Scientific Publ. Ireland
Language:	English
Submitter:	Pubmed Import
Date Deposited:	12 Aug 2024 14:48
Last Modified:	30 Sep 2024 00:15
Publisher DOI:	10.1016/j.radonc.2024.110474
PubMed ID:	39128626
Uncontrolled Keywords:	Carcinoma Extranodal extension Lymph nodes Mouth neoplasms Neck dissection Prevalence Retrospective studies Risk factors Squamous cell Squamous cell carcinoma of head and neck
URI:	https://boris.unibe.ch/id/eprint/199640