Patterns of lymph node involvement for oral cavity squamous cell carcinoma

Area of Science:

• Oncology
• Head and Neck Surgery
• Cancer Research

Background:

• Lymph node level (LNL) involvement is a critical prognostic factor in oral cavity squamous cell carcinomas (OCSCC).
• Previous studies have reported LNL involvement prevalence, but detailed lymphatic progression patterns remain insufficiently quantified.

Purpose of the Study:

• To investigate how the risk of metastases in each LNL is influenced by the involvement of adjacent LNLs.
• To analyze the impact of T-category, subsite, primary tumor lateralization, and other risk factors on lymphatic progression patterns in OCSCC.

Main Methods:

• Retrospective analysis of 348 newly diagnosed OCSCC patients from two institutions.
• Individual recording of LNL I-V involvement based on pathology after neck dissection.
• Utilized a publicly available web-app for data querying based on co-involved LNLs and tumor characteristics.

Main Results:

• Ipsilateral LNL I-III involvement was higher in advanced T-category (T3/T4) OCSCC.
• Involvement of LNL I or II increased the probability of involvement in adjacent levels, though isolated involvement occurred.
• Advanced nodal involvement and contralateral spread were more frequent with extracapsular extension and midline-crossing tumors.

Conclusions:

• Detailed quantification of LNL involvement in OCSCC, considering adjacent LNLs and clinicopathological factors, is crucial.
• This data can inform personalized guidelines for elective nodal treatment in OCSCC patients.