Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 15;11(1):20535.
doi: 10.1038/s41598-021-99925-2.

Prognostic impact of lingual lymph node metastasis in patients with squamous cell carcinoma of the tongue: a retrospective study

Takeshi Kuroshima  1 , Yusuke Onozato  2 , Yu Oikawa  3 , Toshimitsu Ohsako  3 , Takuma Kugimoto  3 , Hideaki Hirai  3 , Hirofumi Tomioka  3 , Yasuyuki Michi  3 , Masahiko Miura  2 , Ryoichi Yoshimura  4 , Hiroyuki Harada  3
Affiliations

Prognostic impact of lingual lymph node metastasis in patients with squamous cell carcinoma of the tongue: a retrospective study

Takeshi Kuroshima et al. Sci Rep. .

Abstract

Squamous cell carcinoma (SCC) of the tongue rarely metastasizes to the lingual lymph nodes (LLNs), which are inconstant nodes and often situated outside the areas of basic tongue tumor surgery. The current study evaluated the clinicopathological features and prognostic impact of LLN metastasis (LLNM), compared to that of cervical lymph node metastasis, in patients with tongue SCC. A total of 608 patients underwent radical surgery for tongue SCC at our department between January 2001 and December 2016. During neck dissection, we scrutinized and resected lateral LLNs, when present. Of the 128 patients with lymph node metastasis, 107 had cervical lymph node metastasis and 21 had both cervical lymph node metastasis and LLNM. Univariate analysis demonstrated that LLNM was significantly associated with the adverse features of cervical lymph node metastasis. The 5-year disease-specific survival (5y-DSS) was significantly lower in patients with LLNMs than in those without LLNMs (49.0% vs. 88.4%, P < 0.01). Moreover, Cox proportional hazards model analyses revealed that cervical lymph node metastasis at level IV or V and LLNM were independent prognostic factors for 5y-DSS. LLNM has a strong negative impact on survival in patients with tongue SCC. An advanced status of cervical lymph node metastasis may predict LLNM.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
T2-weighted magnetic resonance (MR) image showing median lingual lymph node metastasis (LLNM) (arrowhead) in the lingual septum.
Figure 2
Figure 2
Imaging of lateral lingual lymph node metastasis (LLNM) in the sublingual space. Lateral LLNM (arrowhead) is revealed in the sublingual space on the right side on (a) axial T2-weighted magnetic resonance (MR) and (b) coronal T2-weighted MR images. This metastatic node is independent of the primary tongue tumor (arrow). (c) Lateral LLNM (arrowhead) is located in the proximity of the sublingual gland. The mylohyoid muscle is retracted anteriorly.
Figure 3
Figure 3
Imaging of lateral lingual lymph node metastasis (LLNM) in the parahyoid area. Lateral LLNM (arrowhead) is demonstrated in the parahyoid area on the right side on (a) enhanced axial T1-weighted magnetic resonance (MR) and (b) enhanced coronal T1-weighted MR images.
Figure 4
Figure 4
Imaging of subclinical lateral lingual lymph node metastasis in the parahyoid area. Supraomohyoid neck dissection and hemiglossectomy with a pull-through maneuver are performed. The lingual artery is ligated. Lateral lingual lymph node (arrowhead) is revealed below the lingual artery. This node is not shown in preoperative imaging.
Figure 5
Figure 5
Kaplan–Meier survival curves and log-rank tests comparing 5-year disease-specific survival (5y-DSS) in patients with lingual lymph node metastases (LLNM) and patients without LLNM.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ. WHO Classification of Head and Neck Tumours. 4. IARC; 2017.
    1. Brands MT, Brennan PA, Verbeek ALM, Merkx MAW, Geurts SME. Follow-up after curative treatment for oral squamous cell carcinoma. A critical appraisal of the guidelines and a review of the literature. Eur. J. Surg. Oncol. 2018;44:559–565. doi: 10.1016/j.ejso.2018.01.004. - DOI - PubMed
    1. Larsen SR, Johansen J, Sørensen JA, Krogdahl A. The prognostic significance of histological features in oral squamous cell carcinoma. J. Oral Pathol. Med. 2009;38:657–662. doi: 10.1111/j.1600-0714.2009.00797.x. - DOI - PubMed
    1. Oikawa Y, et al. Surgical treatment for oral tongue squamous cell carcinoma: A retrospective study of 432 patients. Glob. Health Med. 2021;3:157–162. doi: 10.35772/ghm.2020.01084. - DOI - PMC - PubMed
    1. Sato J, et al. Hypoxic volume evaluated by 18F-fluoromisonidazole positron emission tomography (FMISO-PET) may be a prognostic factor in patients with oral squamous cell carcinoma: Preliminary analyses. Int. J. Oral Maxillofac. Surg. 2018;47:553–560. doi: 10.1016/j.ijom.2017.09.007. - DOI - PubMed