Prognostic implications of node metastatic features in OSCC: a retrospective study on 121 neck dissections

Contaldo,Maria; Di Napoli,Antonio; Pannone,Giuseppe; Franco,Renato; Ionna,Franco; Feola,Antonia; De Rosa,Alfredo; Santoro,Angela; Sbordone,Carolina; Longo,Francesco; Pasquali,Daniela; Loreto,Carla; Ricciardiello,Filippo; Esposito,Gennaro; D'Angelo,Luigi; Itro,Angelo; Bufo,Pantaleo; Tombolini,Vincenzo; Serpico,Rosario; Di Domenico,Marina

doi:10.3892/or.2013.2779

Prognostic implications of node metastatic features in OSCC: a retrospective study on 121 neck dissections

Authors:
- Maria Contaldo
- Antonio Di Napoli
- Giuseppe Pannone
- Renato Franco
- Franco Ionna
- Antonia Feola
- Alfredo De Rosa
- Angela Santoro
- Carolina Sbordone
- Francesco Longo
- Daniela Pasquali
- Carla Loreto
- Filippo Ricciardiello
- Gennaro Esposito
- Luigi D'Angelo
- Angelo Itro
- Pantaleo Bufo
- Vincenzo Tombolini
- Rosario Serpico
- Marina Di Domenico
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Affiliations: Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples, I-80138 Naples, Italy, Department of Clinical and Experimental Medicine, University of Foggia, I-71122 Foggia, Italy, Section of Pathological Anatomy, National Cancer Institute-G. Pascale Foundation, I-80131 Naples, Italy, Section of Head and Neck Surgery, National Cancer Institute-G. Pascale Foundation, I-80131 Naples, Italy, Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, I-80131 Naples, Italy, Maxillo-Facial Surgery Chair of Maxillo-Facial Surgery, School of Medicine, University of Naples, I-80131 Naples, Italy, Department of Endocrinology, Second University of Naples, I-80131 Naples, Italy, Department of Bio-Medical Sciences, Section of Anatomy, University of Catania, I-95123 Catania, Italy, Section of Otolaryngology, University of Naples Federico II, I-80138 Naples, Italy, Section of II Orthopaedic Cardarelli Hospital, I-80131 Naples, Italy, Department of Radiology, Oncology and Pathological Anatomy Sciences, Sapienza University of Rome, i-00161 Rome, Italy
Published online on: October 2, 2013 https://doi.org/10.3892/or.2013.2779
Pages: 2697-2704

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Abstract

Lymph node metastases are responsible for shorter survival in oral squamous cell carcinoma (OSCC). The aim of the present study was to assess the node metastasis frequency and survival according to the node metastasis features in 121 neck dissections (NDs) performed for OSCC, identifying evidence-based correlations and contrasts with previous literature. The retrospective study involved 121 patients affected by OSCC who had undergone modified radical ND (MRND) for therapeutic, elective reasons or after intraoperative positivity to metastasis of sentinel lymph nodes (SLN+). Node metastasis frequency and behaviour (typical vs. atypical) and their number and distribution according to pre-surgical cTNM cancer staging were considered and overall survival Kaplan-Meier curves were calculated for each group in order to compare mortality according to ND type (elective, therapeutic, after SLN+), lymph node metastatic pattern (typical or atypical), size (micrometastasis vs. macrometastasis) and number. Results showed statistically significant different overall survival according to pre-surgical staging, number of lymph nodes harvested and intent to surgery. Sentinel lymph node resulted in the sole positive node affected by metastasis in small cT1- cT2/cN0 OSCC and an ND subsequent to its positivity during intraoperative assessment may be considered an overtreatment.

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1	Saman DM: A review of the epidemiology of oral and pharyngeal carcinoma: update. Head Neck Oncol. 4:1–7. 2012. View Article : Google Scholar : PubMed/NCBI
2	Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG and Morrow M: AJCC Cancer Staging Handbook. From the AJCC Cancer Staging Manual. 6th edition. Springer-Verlag; 2002, View Article : Google Scholar
3	Edge SB and Compton CC: The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 17:1471–1474. 2010. View Article : Google Scholar : PubMed/NCBI
4	Wenzel S, Sagowski C, Kehrl W and Metternich FU: The prognostic impact of metastatic pattern of lymph nodes in patients with oral and oropharyngeal squamous cell carcinomas. Eur Arch Otorhinolaryngol. 261:270–275. 2004. View Article : Google Scholar : PubMed/NCBI
5	Kowalski LP and Medina JE: Nodal metastases: predictive factors. Otolaryngol Clin North Am. 31:621–637. 1998. View Article : Google Scholar : PubMed/NCBI
6	Amar A, Chedid HM, Rapoport A, Cernea CR, Dedivitis RA, Curioni OA and Brandão LG: Prognostic significance of the number of lymph nodes in elective neck dissection for tongue and mouth floor cancers. Braz J Otorhinolaryngol. 78:22–26. 2012.PubMed/NCBI
7	Compton CC and Byrd DR: Lip and oral cavity. 2nd AJCC Cancer Staging Atlas. Compton CC, Byrd DR, Garcia-Aguilar J, Kurtzman SH, Olawaiye A and Washington MK: Springer; New York: pp. 41–53. 2012, View Article : Google Scholar
8	Ferlito A, Robbins KT, Shah JP, Medina JE, Silver CE, Al-Tamimi S, Fagan JJ, Paleri V, Takes RP, Bradford CR, Devaney KO, Stoeckli SJ, Weber RS, Bradley PJ, Suárez C, Leemans CR, Coskun HH, Pitman KT, Shaha AR, de Bree R, Hartl DM, Haigentz M Jr, Rodrigo JP, Hamoir M, Khafif A, Langendijk JA, Owen RP, Sanabria A, Strojan P, Vander Poorten V, Werner JA, Bień S, Woolgar JA, Zbären P, Betka J, Folz BJ, Genden EM, Talmi YP, Strome M, González Botas JH, Olofsson J, Kowalski LP, Holmes JD, Hisa Y and Rinaldo A: Proposal for a rational classification of neck dissections. Head Neck. 33:445–450. 2011.PubMed/NCBI
9	Byers RM, Wolf PF and Ballantyne AJ: Rationale for elective modified neck dissection. Head Neck Surg. 10:160–167. 1988. View Article : Google Scholar : PubMed/NCBI
10	Pagedar NA and Gilbert RW: Selective neck dissection: a review of the evidence. Oral Oncol. 45:416–420. 2009. View Article : Google Scholar : PubMed/NCBI
11	Ferlito A, Robbins KT, Silver CE, Hasegawa Y and Rinaldo A: Classification of neck dissections: an evolving system. Auris Nasus Larynx. 36:127–134. 2009. View Article : Google Scholar : PubMed/NCBI
12	Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefèbvre JL, Greiner RH, Giralt J, Maingon P, Rolland F, Bolla M, Cognetti F, Bourhis J, Kirkpatrick A and van Glabbeke M: Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med. 350:1945–1952. 2004. View Article : Google Scholar : PubMed/NCBI
13	Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB, Kish JA, Kim HE, Cmelak AJ, Rotman M, Machtay M, Ensley JF, Chao KS, Schultz CJ, Lee N and Fu KK: Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med. 350:1937–1944. 2004. View Article : Google Scholar : PubMed/NCBI
14	van den Brekel MW, van der Waal I, Meijer CJ, Freeman JL, Castelijns JA and Snow GB: The incidence of micrometastases in neck dissection specimens obtained from elective neck dissections. Laryngoscope. 106:987–991. 1996.PubMed/NCBI
15	Murer K, Huber GF, Haile SR and Stoeckli SJ: Comparison of morbidity between sentinel node biopsy and elective neck dissection for treatment of the n0 neck in patients with oral squamous cell carcinoma. Head Neck. 33:1260–1264. 2011. View Article : Google Scholar : PubMed/NCBI
16	Schiefke F, Akdemir M, Weber A, Akdemir D, Singer S and Frerich B: Function, postoperative morbidity, and quality of life after cervical sentinel node biopsy and after selective neck dissection. Head Neck. 31:503–512. 2009. View Article : Google Scholar : PubMed/NCBI
17	Broglie MA, Haile SR and Stoeckli SJ: Long-term experience in sentinel node biopsy for early oral and oropharyngeal squamous cell carcinoma. Ann Surg Oncol. 18:2732–2738. 2011. View Article : Google Scholar : PubMed/NCBI
18	Teymoortash A, Hoch S, Eivazi B and Werner JA: Postoperative morbidity after different types of selective neck dissection. Laryngoscope. 120:924–929. 2010.PubMed/NCBI
19	Robbins KT, Shaha AR, Medina JE, Califano JA, Wolf GT, Ferlito A, Som PM and Day TA; Committee for Neck Dissection Classification, American Head and Neck Society. Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg. 134:536–538. 2008. View Article : Google Scholar : PubMed/NCBI
20	Broglie MA, Haerle SK, Huber GF, Haile SR and Stoeckli SJ: Occult metastases detected by sentinel node biopsy in patients with early oral and oropharyngeal squamous cell carcinomas: impact on survival. Head Neck. 35:660–666. 2013. View Article : Google Scholar : PubMed/NCBI
21	Woolgar JA: The topography of cervical lymph node metastases revisited: the histological findings in 526 sides of neck dissection from 439 previously untreated patients. Int J Oral Maxillofac Surg. 36:219–225. 2007. View Article : Google Scholar : PubMed/NCBI
22	Woolgar JA, Scott J, Vaughan ED, Brown JS, West CR and Rogers S: Survival, metastasis and recurrence of oral cancer in relation to pathological features. Ann R Coll Surg Engl. 77:325–331. 1995.PubMed/NCBI
23	Shah JP: Surgical approaches to the oral cavity primary and neck. Int J Radiat Oncol Biol Phys. 69:S15–S18. 2007. View Article : Google Scholar : PubMed/NCBI
24	Stoeckli SJ, Alkureishi LW and Ross GL: Sentinel node biopsy for early oral and oropharyngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol. 266:787–793. 2009. View Article : Google Scholar : PubMed/NCBI
25	Ross GL, Soutar DS, MacDonald DG, Shoaib T, Camilleri IG and Robertson AG: Improved staging of cervical metastases in clinically node-negative patients with head and neck squamous cell carcinoma. Ann Surg Oncol. 11:213–218. 2004. View Article : Google Scholar : PubMed/NCBI
26	Huber GF, Züllig L, Soltermann A, Roessle M, Graf N, Haerle SK, Studer G, Jochum W, Moch H and Stoeckli SJ: Down regulation of E-Cadherin (ECAD) - a predictor for occult metastatic disease in sentinel node biopsy of early squamous cell carcinomas of the oral cavity and oropharynx. BMC Cancer. 11:2172011. View Article : Google Scholar : PubMed/NCBI
27	Shah JP: Pattern of cervical node metastasis from squamous carcinomas of the upper aerodigestive tract. Am J Surg. 160:405–409. 1990. View Article : Google Scholar : PubMed/NCBI
28	Han MW, Cho KJ, Roh JL, Choi SH, Nam SY and Kim SY: Patterns of lymph node metastasis and their influence on outcomes in patients with submandibular gland carcinoma. J Surg Oncol. 106:475–480. 2012. View Article : Google Scholar : PubMed/NCBI
29	Contaldo M, Agozzino M, Moscarella E, Esposito S, Serpico R and Ardigò M: In vivo characterization of healthy oral mucosa by reflectance confocal microscopy: a translational research for optical biopsy. Ultrastruct Pathol. 37:151–158. 2013. View Article : Google Scholar : PubMed/NCBI
30	Di Domenico M, Pierantoni GM, Feola A, Esposito F, Laino L, DE Rosa A, Rullo R, Mazzotta M, Martano M, Sanguedolce F, Perillo L, D’Angelo L, Papagerakis S, Tortorella S, Bufo P, Lo Muzio L, Pannone G and Santoro A: Prognostic significance of N-Cadherin expression in oral squamous cell carcinoma. Anticancer Res. 31:4211–4218. 2011.PubMed/NCBI