Predictive markers for delayed lymph node metastases and survival in early-stage oral squamous cell carcinoma

Head Neck. 2017 Apr;39(4):694-701. doi: 10.1002/hed.24667. Epub 2016 Dec 22.

Abstract

Background: The purpose of this study was to identify clinicopathological and immunohistochemical factors predicting delayed lymph node metastases and survival in early oral squamous cell carcinoma (OSCC).

Methods: The study included 85 consecutive patients with clinically T1 to T2N0 OSCC who were primarily surgically treated between 2000 and 2004.

Results: There were 68 men and 17 women (median age, 61 years; range, 34-82 years). Of all the patients, 25 (29.4%) developed delayed lymph node metastases within 3 to 42 months after treatment of the primary tumor. Multivariate logistic regression analysis identified poorly differentiated tumors, low laminin, and high fibronectin expression as prognosticators of delayed lymph node metastases. Cox's proportional hazards regression analysis demonstrated that moderately differentiated tumors and delayed lymph node metastases had predictive value regarding survival.

Conclusion: Large prospective investigations with reproducibility and the clinical translatability of immunohistochemical methods are needed in order to provide new and effective therapeutic strategies in the future. © 2016 Wiley Periodicals, Inc. Head Neck 39: 694-701, 2017.

Keywords: delayed lymph node metastases; oral cancer; prognostic factors; recurrence; survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis*
  • Biopsy, Needle
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Fibronectins / analysis
  • Humans
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Laminin / analysis
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis / pathology
  • Male
  • Middle Aged
  • Mouth Neoplasms / mortality*
  • Mouth Neoplasms / pathology*
  • Mouth Neoplasms / therapy
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Analysis

Substances

  • Biomarkers, Tumor
  • Fibronectins
  • Laminin