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Cervical metastases behavior of T1–2 squamous cell cancer of the oral mucosa

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Abstract

Objectives

The clinical management of the neck of patients with early-stage oral squamous cell cancer (OSCC) is still controversially discussed in the current literature. This study analyzes histo-clinical factors influencing the occurrence of cervical lymph node metastases (CM).

Materials and methods

In a retrospective mono-center study, patients with a primary T1–2 OSCC between 2000 and 2014 were analyzed regarding histo-clinical parameters possibly influencing the CM rate and the outcome.

Results

Two hundred eighty-five patients (66 %) were male and 146 female (44 %), with a mean age of 60 ± 12 years at the time of diagnosis. Seventy-seven percent showed a positive risk profile (nicotine/alcohol) and 69 % underlying diseases. Forty-four percent of the patients were staged as T2 (30 % with CM). Advanced tumor size (T1 vs. T2) and grading (G1–2 vs. G3) were statistically significantly (p < 0.001) associated with the occurrence of CM. The localization within the oral cavity, age, gender, risk profile, or underlying diseases had no influence on CM occurrence. During the follow-up, tumor size (p = 0.001), CM (p < 0.001), and tumor relapse (p < 0.001) were significantly associated with a worse outcome.

Conclusions

Early-stage OSCC showed aggressive lymphatic metastatic behavior that depends on the size and the grading of the tumor.

Clinical relevance

A watch-and-wait policy as the primary management for cN0 may likely be inferior to a selective neck dissection for this patient group and should only be considered for very small tumors with a good differentiation.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery—Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany

    Keyvan Sagheb, Sebastian Blatt, Roman-Kia Rahimi-Nedjat, Simone Eigenbrodt, Bilal Al-Nawas & Christian Walter

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  1. Keyvan Sagheb
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  2. Sebastian Blatt
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  3. Roman-Kia Rahimi-Nedjat
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  4. Simone Eigenbrodt
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  5. Bilal Al-Nawas
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  6. Christian Walter
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Correspondence to Keyvan Sagheb.

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Conflict of interest

All authors declare that they have no conflict of interest.

Funding

The study was not sponsored.

Ethical approval

A retrospective study was performed without any further consequences for the patient. Due to this and in accordance with the hospital laws of the individual states (Landeskrankenhausgesetz), no approval by the local ethics committee is necessary.

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For this type of study, formal consent is not required.

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Sagheb, K., Blatt, S., Rahimi-Nedjat, RK. et al. Cervical metastases behavior of T1–2 squamous cell cancer of the oral mucosa. Clin Oral Invest 21, 931–935 (2017). https://doi.org/10.1007/s00784-016-1845-9

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  • DOI: https://doi.org/10.1007/s00784-016-1845-9

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