Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
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A Study on the Clinicopathological Characteristics Associated with Cervical Lymph Mode Metastasis and Extra-nodal Extension in Patients with Oral Cancer

구강암 환자의 경부 림프절 전이 및 림프절 피막 외 침범과 관련된 임상병리적 인자에 대한 고찰

  • Han, Jang Gyu (Department of Otolaryngology, Ajou University School of Medicine, Ajou University Hospital) ;
  • Kim, Seung-il (Biostatics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine) ;
  • Park, Bumhee (Biostatics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine) ;
  • Jang, Jeon Yeob (Department of Otolaryngology, Ajou University School of Medicine, Ajou University Hospital) ;
  • Shin, Yoo Seob (Department of Otolaryngology, Ajou University School of Medicine, Ajou University Hospital) ;
  • Kim, Chul-Ho (Department of Otolaryngology, Ajou University School of Medicine, Ajou University Hospital)
  • 한장규 (아주대학교 의과대학 이비인후과학교실) ;
  • 김승일 (의학연구협력센터 의학통계실) ;
  • 박범희 (의학연구협력센터 의학통계실) ;
  • 장전엽 (아주대학교 의과대학 이비인후과학교실) ;
  • 신유섭 (아주대학교 의과대학 이비인후과학교실) ;
  • 김철호 (아주대학교 의과대학 이비인후과학교실)
  • Received : 2021.07.04
  • Accepted : 2021.09.13
  • Published : 2021.11.30
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Abstract

Background/Objectives: Extra-nodal extension (ENE) is one of the strongest prognosticators in oral cancers. Here we tried to evaluate clinicopathological factors associated with the presence of ENE. Materials & Methods: We retrospectively analyzed clinical information of 120 patients who diagnosed with oral cancer and received curative surgery at our hospital from Mar 2012 to Apr 2020. We comparatively analyzed clinicopathological factors associated with the presence of lymph node (LN) metastasis and ENE, respectively. Results: Variable factors of primary tumor characteristics such as lymphovascular invasion, perineural invasion, largest diameter of tumor, depth of invasion and maximum standardized uptake value were significantly associated with the presence of cervical LN metastasis. The largest diameter of tumor was statistically significant also in multivariate analysis for predicting the LN metastasis. Meanwhile, the association between primary tumor characteristics and the presence of ENE were not statistically significant except the primary tumor size. Importantly, factors associated with LN characteristics including the maximum diameter and number of metastatic LNs were significantly associated with ENE. Conclusion: In this study, several factors affecting cervical LN metastasis and ENE in oral cancer patients were identified. The ENE seems to be influenced by the status of the metastatic LNs, such as the number of metastatic LNs, rather than the characteristics of the primary tumor itself.

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References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69-90. https://doi.org/10.3322/caac.20107
  2. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63:11-30. https://doi.org/10.3322/caac.21166
  3. Ghantous Y, Abu Elnaaj I. Global incidence and risk factors of oral cancer. Harefuah. 2017;156:645-649.
  4. Blot WJ, McLaughlin JK, Winn DM, Austin DF, Greenberg RS, Preston-Martin S, et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res. 1988;48:3282-3287.
  5. Pulte D, Brenner H. Changes in survival in head and neck cancers in the late 20th and early 21st century: A period analysis. Oncologist. 2010;15:994-1001. https://doi.org/10.1634/theoncologist.2009-0289
  6. Bagan J, Sarrion G, Jimenez Y. Oral cancer: Clinical features. Oral Oncol. 2010;46:414-417. https://doi.org/10.1016/j.oraloncology.2010.03.009
  7. Magnano M, De Stefani A, Lerda W, Usai A, Ragona R, Bussi M, et al. Prognostic factors of cervical lymph node metastasis in head and neck squamous cell carcinoma. Tumori. 1997;83:922-926. https://doi.org/10.1177/030089169708300610
  8. Pilborough AE, Lambert DW, Khurram SA. Extranodal extension in oral cancer: A role for the nodal microenvironment? J Oral Pathol Med. 2019;48:863-870. https://doi.org/10.1111/jop.12870
  9. Shaw RJ, Lowe D, Woolgar JA, Brown JS, Vaughan ED, Evans C, et al. Extracapsular spread in oral squamous cell carcinoma. Head Neck. 2010;32:714-722. https://doi.org/10.1002/hed.21244
  10. International Consortium for Outcome Research (ICOR) in Head and Neck Cancer. Primary tumor staging for oral cancer and a proposed modification incorporating depth of invasion: An international multicenter retrospective study. JAMA Otolaryngol Head Neck Surg. 2014;140:1138-1148. https://doi.org/10.1001/jamaoto.2014.1548
  11. Huang SH, Hwang D, Lockwood G, Goldstein DP, O'Sullivan B. Predictive value of tumor thickness for cervical lymph-node involvement in squamous cell carcinoma of the oral cavity: A meta-analysis of reported studies. Cancer. 2009;115:1489-1497. https://doi.org/10.1002/cncr.24161
  12. Piazza C, Bresciani L, Giannini L. Depth of invasion for prognostic stratification in oral cavity cancer: Do we need further validation? Ann Transl Med. 2019;7:S84. https://doi.org/10.21037/atm.2019.04.19
  13. Abdel-Halim CN, Rosenberg T, Larsen SR, Hoilund-Carlsen PF, Sorensen JA, Rohde M, et al. Histopathological definitions of extranodal extension: A systematic review. Head Neck Pathol. 2021;15:599-607. https://doi.org/10.1007/s12105-020-01221-4
  14. Kann BH, Hicks DF, Payabvash S, Mahajan A, Du J, Gupta V, et al. Multi-institutional validation of deep learning for pretreatment identification of extranodal extension in head and neck squamous cell carcinoma. J Clin Oncol. 2020;38:1304-1311. https://doi.org/10.1200/jco.19.02031
  15. Su Z, Duan Z, Pan W, Wu C, Jia Y, Han B, et al. Predicting extracapsular spread of head and neck cancers using different imaging techniques: A systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2016;45:413-421. https://doi.org/10.1016/j.ijom.2015.11.021
  16. Mair MD, Shetty R, Nair D, Mathur Y, Nair S, Deshmukh A, et al. Depth of invasion, size and number of metastatic nodes predicts extracapsular spread in early oral cancers with occult metastases. Oral Oncol. 2018;81:95-99. https://doi.org/10.1016/j.oraloncology.2018.04.015
  17. Cerezo L, Millan I, Torre A, Aragon G, Otero J. Prognostic factors for survival and tumor control in cervical lymph node metastases from head and neck cancer. A multivariate study of 492 cases. Cancer. 1992;69:1224-1234. https://doi.org/10.1002/cncr.2820690526
  18. Ho AS, Kim S, Tighiouart M, Gudino C, Mita A, Scher KS, et al. Metastatic lymph node burden and survival in oral cavity cancer. J Clin Oncol. 2017;35:3601-3609. https://doi.org/10.1200/JCO.2016.71.1176
  19. Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, et al. The eighth edition AJCC cancer staging manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging. CA Cancer J Clin. 2017;67:93-99. https://doi.org/10.3322/caac.21388
  20. Mermod M, Tolstonog G, Simon C, Monnier Y. Extracapsular spread in head and neck squamous cell carcinoma: A systematic review and meta-analysis. Oral Oncol. 2016;62:60-71. https://doi.org/10.1016/j.oraloncology.2016.10.003
  21. Yamada S, Yanamoto S, Otani S, Hasegawa T, Miyakoshi M, Minamikawa T, et al. Evaluation of the level of progression of extracapsular spread for cervical lymph node metastasis in oral squamous cell carcinoma. Int J Oral Maxillofac Surg. 2016;45:141-146. https://doi.org/10.1016/j.ijom.2015.09.005