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Prognostic significance of the distribution of neck node metastasis from oral carcinoma
Author(s) -
Kowalski Luiz P.,
Bagietto Rogério,
Lara José R. L.,
Santos Rogério L.,
Silva Jordão F.,
Magrin José
Publication year - 2000
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/(sici)1097-0347(200005)22:3<207::aid-hed1>3.0.co;2-9
Subject(s) - medicine , neck dissection , lymph node , metastasis , lymph , stage (stratigraphy) , lymph node metastasis , multivariate analysis , oncology , carcinoma , t stage , risk factor , primary tumor , cancer , basal cell , proportional hazards model , surgery , pathology , biology , paleontology
Background Carcinoma of the oral cavity presents a high risk for neck metastasis, which reduces the probability of regional control and survival. Objectives The main objective of this study is to analyze prognostic implications of the distribution of neck metastasis in 513 patients with squamous cell carcinoma of the oral cavity. Patients and methods All patients underwent surgery from 1970–1992. Tumor stages were I, 63; II, 120; III, 173; and IV, 157. Neck dissections were performed in 448 patients (115 bilateral). Results By use of multivariate regression techniques the level of lymph node involvement was the most important prognostic factor (relative risks from 1.8 to 2.5). The following variables were also associated with prognosis: mobility of lymph nodes, sex, T stage, age, and tumor thickness. Conclusions The level of ipsilateral lymph node involvement was the most significant prognostic factor patients with in oral cancer who underwent surgical treatment. A significant decrease in survival also was seen with regard to the involvement of multiple contralateral lymph nodes. Our results support the indication of elective neck dissections in high‐risk patients because among the cases that had metastases at follow‐up, 50% were not candidates for salvage treatment. © 2000 John Wiley & Sons, Inc. Head Neck 22: 207–214, 2000.