Clinical Trial

. 2023 Apr;28(4):512-520.

doi: 10.1007/s10147-023-02305-1. Epub 2023 Feb 16.

Macroscopic and multiple metastases in sentinel lymph node biopsy are respectively associated with poor prognosis in early oral cancer

Takahito Kondo¹, Kiyoaki Tsukahara², Daisuke Kawakita³, Seiichi Yoshimoto⁴, Kouki Miura⁵, Masashi Sugasawa⁶, Kazuaki Chikamatsu⁷, Takashi Matsuzuka⁸, Isao Oze⁹, Morimasa Kitamura¹⁰, Yoshiko Murakami¹¹, Shinji Otozai¹², Takeshi Shinozaki¹³, Shinichi Ohba¹⁴, Koji Araki¹⁵, Takatsugu Mizumachi¹⁶, Dai Sato¹⁷, Naohiro Wakisaka¹⁸, Hitoshi Hirakawa¹⁹, Yasuhisa Hasegawa⁸

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo, 193-0998, Japan.
² Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. tsuka@tokyo-med.ac.jp.
³ Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-shi, Aichi, 467-8601, Japan.
⁴ Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
⁵ Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan.
⁶ Department of Head and Neck Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan.
⁷ Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-15 Showa-cho, Maebashi-shi, Gunma, 371-8511, Japan.
⁸ Department of Head and Neck Surgery-Otolaryngology, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu-shi, Gifu, 500-8523, Japan.
⁹ Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya-shi, Aichi, 464-8681, Japan.
¹⁰ Department of Head and Neck Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada-cho, Kahoku-gun, Ishikawa, 920-0293, Japan.
¹¹ Department of Pathological Diagnosis, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya-shi, Aichi, 460-0001, Japan.
¹² Department of Head and Neck Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka-shi, Osaka, 541-8567, Japan.
¹³ Department of Head and Neck Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan.
¹⁴ Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.
¹⁵ Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan.
¹⁶ Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 14, Nishi 5, Kita-ku, Sapporo-shi, Hokkaido, 060-8648, Japan.
¹⁷ Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan.
¹⁸ Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa-shi, Ishikawa, 920-8641, Japan.
¹⁹ Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan.

PMID: 36795281
DOI: 10.1007/s10147-023-02305-1

Clinical Trial

Macroscopic and multiple metastases in sentinel lymph node biopsy are respectively associated with poor prognosis in early oral cancer

Takahito Kondo et al. Int J Clin Oncol. 2023 Apr.

. 2023 Apr;28(4):512-520.

doi: 10.1007/s10147-023-02305-1. Epub 2023 Feb 16.

Authors

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo, 193-0998, Japan.
² Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. tsuka@tokyo-med.ac.jp.
³ Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-shi, Aichi, 467-8601, Japan.
⁴ Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
⁵ Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan.
⁶ Department of Head and Neck Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan.
⁷ Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-15 Showa-cho, Maebashi-shi, Gunma, 371-8511, Japan.
⁸ Department of Head and Neck Surgery-Otolaryngology, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu-shi, Gifu, 500-8523, Japan.
⁹ Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya-shi, Aichi, 464-8681, Japan.
¹⁰ Department of Head and Neck Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada-cho, Kahoku-gun, Ishikawa, 920-0293, Japan.
¹¹ Department of Pathological Diagnosis, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya-shi, Aichi, 460-0001, Japan.
¹² Department of Head and Neck Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka-shi, Osaka, 541-8567, Japan.
¹³ Department of Head and Neck Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan.
¹⁴ Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.
¹⁵ Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan.
¹⁶ Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 14, Nishi 5, Kita-ku, Sapporo-shi, Hokkaido, 060-8648, Japan.
¹⁷ Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan.
¹⁸ Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa-shi, Ishikawa, 920-8641, Japan.
¹⁹ Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan.

PMID: 36795281
DOI: 10.1007/s10147-023-02305-1

Abstract

Background: A multicenter, randomized controlled phase III trial was conducted on sentinel lymph node biopsy (SLNB) and elective neck dissection for T1 (depth of invasion ≥ 4 mm)-T2N0M0 oral cavity squamous cell carcinoma. This study identified factors associated with poor prognosis in patients who underwent SLNB based on a subgroup analysis of this trial.

Methods: We analyzed 418 sentinel lymph nodes (SLNs) from 132 patients who underwent SLNB. The metastatic SLNs were classified into three categories based on size-isolated tumor cells: < 0.2 mm, micrometastasis: ≥ 0.2 mm and < 2 mm, and macrometastasis: ≥ 2 mm. Three groups were formed based on the number of metastatic SLNs: no metastasis, 1 metastatic node, and ≥ 2 metastatic nodes. The size and number of metastatic SLNs on survival were evaluated using Cox proportional hazard models.

Results: Patients with macrometastasis and ≥ 2 metastatic SLNs had worse overall survival (OS) and disease-free survival (DFS) after adjustment for potential confounders (HR for OS: macrometastasis, 4.85; 95% CI 1.34-17.60; ≥ 2 metastatic SLN, 3.63; 95% CI 1.02-12.89; HR for DFS: macrometastasis, 2.94; 95% CI 1.16-7.44; ≥ 2 metastatic SLN, 2.97; 95% CI 1.18-7.51).

Conclusions: In patients who underwent SLNB, a poorer prognosis was associated with macrometastasis or having ≥ 2 metastatic SLNs.

Keywords: Neck dissection; Oral cancer; Sentinel lymph node.

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Macroscopic and multiple metastases in sentinel lymph node biopsy are respectively associated with poor prognosis in early oral cancer

Affiliations

Macroscopic and multiple metastases in sentinel lymph node biopsy are respectively associated with poor prognosis in early oral cancer

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