Virchows Archiv

, Volume 472, Issue 5, pp 797–805 | Cite as

Postoperative radiotherapy is dispensable for OSCC patients with micrometastases in lymph nodes

  • Y. M. Pu
  • Y. Yang
  • Y. J. Wang
  • L. Ding
  • X. F. Huang
  • Z. Y. Wang
  • Y. H. Ni
  • Q. G. Hu
Original Article


Lymph node metastasis is a decisive factor for performing postoperative radiotherapy for oral squamous cell carcinoma (OSCC). However, whether OSCC patients with only micrometastasis need postoperative radiotherapy is unclear. In this study, OSCC patients (n = 311) with negative (n = 247), only micrometastasis (n = 44) and macrometastasis (n = 20) were detected and selected by HE staining. Micrometastasis was re-assessed using immunohistochemical staining of cytokeratin (CK) in HE-negative patients to find out the false negative cases. The results indicated that, among the negative lymph node cases (n = 247), the positive rate of CK was 4.94% (n = 12). Besides, the clinical features of the primary tumor in relation to the only micrometastatic status and the value of the postoperative radiotherapy on the only micrometastasis patients were evaluated. Patients with only micrometastasis had higher T stage and inferior worst pattern of invasion (WPOI) than patients without micrometastasis, but they had longer overall survival (OS), metastasis-free survival (MFS), and disease-free survival (DFS) than macrometastasis patients. However, the survival time of only micrometastasis patients with or without postoperative radiotherapy was comparable, even in patients with inferior WPOI. Radiotherapy, however, may only benefit patients with IV/V levels of micrometastasis. These data indicated that postoperative radiotherapy is dispensable for only micrometastasis OSCC patients.


Oral squamous cell carcinoma Micrometastasis Radiotherapy Prognosis Worst pattern of invasion 



This work was supported by a grant from the National Natural Science Foundation of China (Nos. 81402238, 81072213, and 81271698), the Nanjing Medical Science & Research Project (No. YKK13145), National Key Disciplines Constructional Project Funding (since 2011), Nanjing Municipal Key Medical Laboratory Constructional Project Funding (since 2012), Center of Nanjing Clinical Medicine of tumor project (since 2014), Jiangsu Provincial Commission of Health and Family Planning Project, China (Z201516) and Nanjing Medical Science and Technique Development Foundation.

Compliance with ethical standards

This retrospective study included patients diagnosed with primary OSCC in the Department of Pathology, Nanjing Stomatology Hospital, from 2010 to 2013. The use of samples and retrieval of data were approved by the Research Ethics Committee of Nanjing Stomatology Hospital.

Conflict of interest



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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial Surgery, Nanjing Stomatological HospitalMedical School of Nanjing UniversityNanjingPeople’s Republic of China
  2. 2.Department of Central Laboratory, Nanjing Stomatological HospitalMedical School of Nanjing UniversityNanjingPeople’s Republic of China
  3. 3.Nanjing Stomatological Hospital and The State Key Laboratory of Pharmaceutical Biotechnology, Division of ImmunologyMedical School of Nanjing UniversityNanjingPeople’s Republic of China

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