A multicenter retrospective study of the clinical outcomes of patients with delayed cervical lymph node metastasis in stage I-II squamous cell carcinoma of the oral cavity

  • Yanamoto Souichi
    Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences
  • Ueda Michihiro
    Department of Oral and Maxillofacial Surgery, Keiyukai Sapporo Hospital
  • Yamashita Tetsuro
    Department of Oral and Maxillofacial Surgery, Keiyukai Sapporo Hospital
  • Ota Yoshihide
    Department of Oral and Maxillofacial Surgery, Division of Surgery, Tokai University School of Medicine
  • Otsuru Mitsunobu
    Department of Oral and Maxillofacial Surgery, Division of Surgery, Tokai University School of Medicine
  • Kurita Hiroshi
    Department of Dentistry and Oral Surgery, Shinshu University School of Medicine
  • Kamata Takahiro
    Department of Dentistry and Oral Surgery, Shinshu University School of Medicine
  • Okura Masaya
    First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry
  • Aikawa Tomonao
    First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry
  • Komori Takahide
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine
  • Shigeta Takashi
    Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine
  • Kirita Tadaaki
    Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University
  • Yamakawa Nobuhiro
    Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University
  • Umeda Masahiro
    Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences

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Other Title
  • 口腔扁平上皮癌stage I, IIにおける後発頸部リンパ節転移例の治療成績に関する多施設共同後ろ向き研究

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Abstract

To evaluate the clinical outcomes of patients with delayed cervical lymph node metastasis in stage I-II squamous cell carcinoma (SCC) of the oral cavity, we performed a multicenter retrospective study. We analyzed the records of 141 patients with delayed cervical lymph node metastasis admitted to hospitals between 2002 and 2011. Survival rates of the subjects were compared with those of 27 patients who underwent elective neck dissection (END).<br>The 5-year cumulative disease-specific survival and overall survival rates were 75.7% and 68.9%, respectively. In patients with delayed cervical lymph node metastasis, radical neck dissection or modified radical neck dissection should be performed. Univariate and multivariate analyses showed that variables independently prognostic for survival were multiple nodal metastases, ipsilateral lower neck metastasis (level IV/V), and extracapsular spread. In patients with these prognostic factors, postoperative adjuvant therapy should be performed. Because there is little difference between the wait-and-see policy and END, we believe that END is unnecessary if there is strict follow-up observation. However, to further improve the survival of stage I-II SCC of the oral cavity, it is necessary to elucidate the predictive factors for occult metastasis and conduct a large prospective clinical trial.

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