Tumour infiltration depth 猢? mm is an indication for an elective neck dissection in pT1cN0 oral squamous cell carcinoma

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• 作者：L.J. Melchers^a ; ^b ; ^{L.J.Melchers@umcg.nl} ; E. Schuuring^b ; B.A.C. van Dijk^c ; G.H. de Bock^d ; M.J.H. Witjes^a ; B.F.A.M. van der Laan^e ; J.E. van der Wal^b ; ^f ; ^g ; J.L.N. Roodenburg^a ; ^g
• 关键词：Oral cancer ; Head and neck cancer ; Infiltration depth ; Invasion depth ; Tumour thickness ; Occult metastases ; Elective neck dissection
• 刊名：Oral Oncology
• 出版年：2012
• 期刊代码：213_13688375
• 类别：med
• 出版时间：April, 2012
• 卷：48
• 期：4
• 页码：337-342
• 文件大小：333 K

摘要

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Summary

Patients with pT1cN0 oral squamous cell carcinomas (OSCC) are generally not treated with a neck dissection (ND). However, in 25%of cN0 patients, nodal metastases become apparent during follow-up. Infiltration depth of the primary tumour has been consistently associated with the presence of nodal metastasis, but proposed cut-off depths for performing a ND vary considerably. The aim of this study was to explore the infiltration depth as predictor for the nodal status and to recommend a cut-off depth for performing a ND.

From our database of 351 primary oral carcinomas, we selected all pT1-2 tumours (n = 246). Infiltration depth was measured in 212 cases. Neck status was determined by histopathological examination of the dissection specimen, or by at least two years of follow-up.

Mean infiltration depth was 5.49 mm (95%CI: 4.86-6.12) in the N0 and 8.40 mm (95%CI: 7.38-9.43) in the N+ group (p < 0.001). cN status, lymphovascular invasion and infiltration depth were the only independent predictors for nodal status in multiple logistic regression. ROC-analysis on pT1cN0 tumours resulted in an optimal cut-off for the prediction of the nodal status at a depth of 4.59 mm. This cut-off identified a subgroup of patients at increased risk for nodal metastasis (OR = 8.3) and with significantly shorter survival.

Tumour infiltration depth is an independent predictor for nodal status in pT1-2 OSCC. In pT1cN0 tumours, a cut-off at 4.59 mm results in the best predictive value.

We recommend an infiltration depth of 猢? mm as an indication to perform a neck dissection in pT1cN0 OSCC.