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Predictive factors for late cervical metastasis in stage I and II squamous cell carcinoma of the lip

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Abstract

Purpose

Many authors have described clinicopathologic parameters as factors related to cervical lymph node metastasis development in CN0 stage lip cancer. However, predictive factors for occult lymph node metastasis and criteria for elective neck dissection, especially for early tumour, remain undefined.

Methods

A multi-institutional study with 193 consecutive patients with early lip SCC treated from January 1990 to March 2006 was carried out retrospectively to determine factors predicting occult metastasis.

Results

The overall late LNM rate was 13% (25/193). In the multivariate logistic regression study, tumour size and pattern of tumour invasion were factors related to the occurrence of late LNM with rates of sensitivity, specifity and accuracy for occult LNM prediction of 50%, 89.5% and 87%, respectively.

Conclusion

Our results indicate that patients with stage I and II SCC of the lip with tumour size greater than 18 mm and more aggressive pattern of invasion must be considered a high-risk group for LNM and an END should be performed.

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Acknowledgements

The authors thank Professor Pedro Michaluart Jr (in memoriam) at the Department of Head and Neck Surgery of Hospital das Clínicas-University of São Paulo School of Medicine, São Paulo, Brazil, for support.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Surgery, Head and Neck Surgery Division, Statistic Division of Santa Casa de Sao Paulo School of Medical Sciences, Rua Doutor Cesário Mota Junior, 112–Bairro: Vila Buarque, São Paulo/SP, CEP: 01221-020, Brazil

    Norberto K. Kavabata & Antonio J. Gonçalves

  2. Department of Social Medicine, Statistic Division of Santa Casa de Sao Paulo School of Medical Sciences, Rua Doutor Cesário Mota Junior, 112, São Paulo/SP, CEP: 01221-020, Brazil

    Ting H. Ching

  3. Department of Pathology of Hospital Heliópolis, Rua: Cônego Xavier, 276, São Paulo/SP, CEP 04231-030, Brazil

    Décio N. Caly

  4. Department of Head and Neck Surgery and Otorhinolaryngology of Hospital A.C.Camargo, Rua Prof. Antonio Prudente, 211, São Paulo/SP, CEP 01509-010, Brazil

    Luis P. Kowalski

  5. Department of Head and Neck Surgery of Hospital das Clínicas, University of São Paulo School of Medicine, Av. Dr. Enéas de Carvalho Aguiar, 255, São Paulo/SP, CEP 05403-000, Brazil

    Cláudio R. Cernea

Authors
  1. Norberto K. Kavabata
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Correspondence to Norberto K. Kavabata.

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The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by all four Ethics Committees of the participating institutions (protocols 228/03, 774/04, 605/04 and 291/04) and all procedures performed in study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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A formal consent was released by all four Ethics Committees due to the retrospective nature of the study.

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Kavabata, N.K., Caly, D.N., Ching, T.H. et al. Predictive factors for late cervical metastasis in stage I and II squamous cell carcinoma of the lip. Eur Arch Otorhinolaryngol 276, 2047–2053 (2019). https://doi.org/10.1007/s00405-019-05457-x

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  • DOI: https://doi.org/10.1007/s00405-019-05457-x

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