Skip to main content

Advertisement

SpringerLink
Log in

Cervical Metastases Behavior of T1–2 Squamous Cell Carcinoma of the Tongue

  • Research Paper
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Introduction

The cervical lymph node metastasis (CM) is one of the most important prognostic factors for oral squamous cell carcinoma. Although the frequency and distribution of CM for tongue carcinoma (TC) are well documented in the literature, there is only little data on metastasis patterns depending on the location of the cancer within the tongue.

Materials and Methods

In a retrospective study all patients with a T1–T2 TC who were treated between 1997 and 2013 were analysed regarding epidemiological data, risk factors, and tumour parameters such as exact localization, CM.

Results

204 patients (59 ± 15 years; ♀37 %, ♂63 %) were included. At the initial diagnosis 23 % had an advanced tumour stage (III–IV) due to CM. The occurrence of CM was significantly higher for T2, advanced G-status and the localization in the posterior area of the tongue. The presence of CM—but not the recurrence—had a significant influence on the survival rate.

Conclusion

The small TC has an aggressive metastatic behaviour depending not only on the classical prognostic factors such as grading and tumour size, but is also strongly influenced by the posterior location within the tongue.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Argiris A, Karamouzis MV, Raben D, Ferris RL (2008) Head and neck cancer. Lancet 371(9625):1695–1709. doi:10.1016/S0140-6736(08)60728-X

    Article  CAS  PubMed  Google Scholar 

  2. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T et al (2008) Cancer statistics, 2008. CA Cancer J Clin 58(2):71–96. doi:10.3322/CA.2007.0010

    Article  PubMed  Google Scholar 

  3. Capote A, Escorial V, Munoz-Guerra MF, Rodriguez-Campo FJ, Gamallo C, Naval L (2007) Elective neck dissection in early-stage oral squamous cell carcinoma—does it influence recurrence and survival? Head Neck 29(1):3–11. doi:10.1002/hed.20482

    Article  PubMed  Google Scholar 

  4. Hiratsuka H, Miyakawa A, Nakamori K, Kido Y, Sunakawa H, Kohama G (1997) Multivariate analysis of occult lymph node metastasis as a prognostic indicator for patients with squamous cell carcinoma of the oral cavity. Cancer 80(3):351–356

    Article  CAS  PubMed  Google Scholar 

  5. Kowalski LP, Bagietto R, Lara JR, Santos RL, Tagawa EK, Santos IR (1999) Factors influencing contralateral lymph node metastasis from oral carcinoma. Head Neck 21(2):104–110

    Article  CAS  PubMed  Google Scholar 

  6. Woolgar JA (2007) 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(3):219–225. doi:10.1016/j.ijom.2006.10.014

    Article  CAS  PubMed  Google Scholar 

  7. Mishra P, Sharma AK (2010) A 3-year study of supraomohyoid neck dissection and modified radical neck dissection type I in oral cancer: with special reference to involvement of level IV node metastasis. Eur Arch Otorhinolaryngol 267(6):933–938. doi:10.1007/s00405-009-1155-9

    Article  PubMed  Google Scholar 

  8. Yuen AP, Ho CM, Chow TL, Tang LC, Cheung WY, Ng RW et al (2009) Prospective randomized study of selective neck dissection versus observation for N0 neck of early tongue carcinoma. Head Neck 31(6):765–772. doi:10.1002/hed.21033

    Article  PubMed  Google Scholar 

  9. Monroe MM, Gross ND (2012) Evidence-based practice: management of the clinical node-negative neck in early-stage oral cavity squamous cell carcinoma. Otolaryngol Clin N Am 45(5):1181–1193. doi:10.1016/j.otc.2012.06.016

    Article  Google Scholar 

  10. Sagheb K, Sagheb K, Taylor KJ, Al-Nawas B, Walter C (2014) Cervical metastases of squamous cell carcinoma of the maxilla: a retrospective study of 25 years. Clin Oral Invest 18(4):1221–1227. doi:10.1007/s00784-013-1070-8

    Article  CAS  Google Scholar 

  11. Chiu RJ, Myers EN, Johnson JT (2004) Efficacy of routine bilateral neck dissection in the management of supraglottic cancer. Otolaryngol–Head Neck Surg 131(4):485–488. doi:10.1016/j.otohns.2004.04.024

    Article  PubMed  Google Scholar 

  12. Feng Z, Li JN, Li CZ, Guo CB (2014) Elective neck dissection versus observation in the management of early tongue carcinoma with clinically node-negative neck: a retrospective study of 229 cases. J Craniomaxillofac Surg 42(6):806–810. doi:10.1016/j.jcms.2013.11.016

    Article  PubMed  Google Scholar 

  13. Haddadin KJ, Soutar DS, Oliver RJ, Webster MH, Robertson AG, MacDonald DG (1999) Improved survival for patients with clinically T1/T2, N0 tongue tumors undergoing a prophylactic neck dissection. Head Neck 21(6):517–525

    Article  CAS  PubMed  Google Scholar 

  14. Sano D, Myers JN (2007) Metastasis of squamous cell carcinoma of the oral tongue. Cancer Metastasis Rev 26(3–4):645–662. doi:10.1007/s10555-007-9082-y

    Article  CAS  PubMed  Google Scholar 

  15. Shear M, Hawkins DM, Farr HW (1976) The prediction of lymph node metastases from oral squamous carcinoma. Cancer 37(4):1901–1907

    Article  CAS  PubMed  Google Scholar 

  16. Luan XW, Mao C, Yu GY, Guo CB, Huang MX, Ma DQ (2006) Analysis on occult micrometastasis in levels III–IV of cN0 neck in patients with oral tongue squamous cell carcinoma. Hua Xi Kou Qiang Yi Xue Za Zhi 24(2):128–130

    PubMed  Google Scholar 

  17. Dias FL, Lima RA, Kligerman J, Farias TP, Soares JR, Manfro G et al (2006) Relevance of skip metastases for squamous cell carcinoma of the oral tongue and the floor of the mouth. Otolaryngol–Head Neck Surg 134(3):460–465. doi:10.1016/j.otohns.2005.09.025

    Article  PubMed  Google Scholar 

  18. Rivera C (2015) Essentials of oral cancer. Int J Clin Exp Pathol 8(9):11884–11894

    PubMed  PubMed Central  Google Scholar 

  19. Johnson NW (2001) Aetiology and risk factors for oral cancer, with special reference to tobacco and alcohol use. Magy Onkol 45(2):115–122

    CAS  PubMed  Google Scholar 

  20. Petti S (2009) Lifestyle risk factors for oral cancer. Oral Oncol 45(4–5):340–350. doi:10.1016/j.oraloncology.2008.05.018

    Article  PubMed  Google Scholar 

  21. Rusthoven KE, Raben D, Song JI, Kane M, Altoos TA, Chen C (2010) Survival and patterns of relapse in patients with oral tongue cancer. J Oral Maxillofac Surg 68(3):584–589. doi:10.1016/j.joms.2009.03.056

    Article  PubMed  Google Scholar 

  22. Kademani D, Bell RB, Bagheri S, Holmgren E, Dierks E, Potter B et al (2005) Prognostic factors in intraoral squamous cell carcinoma: the influence of histologic grade. J Oral Maxillofac Surg 63(11):1599–1605. doi:10.1016/j.joms.2005.07.011

    Article  PubMed  Google Scholar 

  23. Kowalski LP, Sanabria A (2007) Elective neck dissection in oral carcinoma: a critical review of the evidence. Acta otorhinolaryngologica Italica: organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale 27(3):113–117

    CAS  Google Scholar 

  24. Wolff KD, Follmann M, Nast A (2012) The diagnosis and treatment of oral cavity cancer. Deutsch Arzteblatt Int 109(48):829–835. doi:10.3238/arztebl.2012.0829

    Google Scholar 

  25. Ren ZH, Xu JL, Li B, Fan TF, Ji T, Zhang CP (2015) Elective versus therapeutic neck dissection in node-negative oral cancer: evidence from five randomized controlled trials. Oral Oncol 51(11):976–981. doi:10.1016/j.oraloncology.2015.08.009

    Article  PubMed  Google Scholar 

  26. D’Cruz AK, Vaish R, Kapre N, Dandekar M, Gupta S, Hawaldar R et al (2015) Elective versus therapeutic neck dissection in node-negative oral cancer. N Engl J Med 373(6):521–529. doi:10.1056/NEJMoa1506007

    Article  PubMed  Google Scholar 

  27. van den Brekel MW, van der Waal I, Meijer CJ, Freeman JL, Castelijns JA, Snow GB (1996) The incidence of micrometastases in neck dissection specimens obtained from elective neck dissections. Laryngoscope 106(8):987–991

    Article  PubMed  Google Scholar 

  28. Ferlito A, Shaha AR, Rinaldo A (2002) The incidence of lymph node micrometastases in patients pathologically staged N0 in cancer of oral cavity and oropharynx. Oral Oncol 38(1):3–5

    Article  CAS  PubMed  Google Scholar 

  29. Cho JH, Lee YS, Sun DI, Kim MS, Cho KJ, Nam IC et al (2015) Prognostic impact of lymph node micrometastasis in oral and oropharyngeal squamous cell carcinomas. Head Neck. doi:10.1002/hed.24314

    Google Scholar 

  30. Hamoir M, Schmitz S, Gregoire V (2014) The role of neck dissection in squamous cell carcinoma of the head and neck. Curr Treat Options Oncol 15(4):611–624. doi:10.1007/s11864-014-0311-7

    Article  PubMed  Google Scholar 

  31. Sparano A, Weinstein G, Chalian A, Yodul M, Weber R (2004) Multivariate predictors of occult neck metastasis in early oral tongue cancer. Otolaryngol—Head Neck Surg 131(4):472–476. doi:10.1016/j.otohns.2004.04.008

    Article  PubMed  Google Scholar 

  32. Keski-Santti H, Atula T, Tikka J, Hollmen J, Makitie AA, Leivo I (2007) Predictive value of histopathologic parameters in early squamous cell carcinoma of oral tongue. Oral Oncol 43(10):1007–1013. doi:10.1016/j.oraloncology.2006.11.015

    Article  PubMed  Google Scholar 

  33. Pimenta Amaral TM, Da Silva Freire AR, Carvalho AL, Pinto CA, Kowalski LP (2004) Predictive factors of occult metastasis and prognosis of clinical stages I and II squamous cell carcinoma of the tongue and floor of the mouth. Oral Oncol 40(8):780–786. doi:10.1016/j.oraloncology.2003.10.009

    Article  PubMed  Google Scholar 

  34. Oc P, Pillai G, Patel S, Fisher C, Archer D, Eccles S et al (2003) Tumour thickness predicts cervical nodal metastases and survival in early oral tongue cancer. Oral Oncol 39(4):386–390

    Article  Google Scholar 

  35. Kurokawa H, Yamashita Y, Takeda S, Zhang M, Fukuyama H, Takahashi T (2002) Risk factors for late cervical lymph node metastases in patients with stage I or II carcinoma of the tongue. Head Neck 24(8):731–736. doi:10.1002/hed.10130

    Article  PubMed  Google Scholar 

  36. Yuen AP, Lam KY, Wei WI, Lam KY, Ho CM, Chow TL et al (2000) A comparison of the prognostic significance of tumor diameter, length, width, thickness, area, volume, and clinicopathological features of oral tongue carcinoma. Am J Surg 180(2):139–143

    Article  CAS  PubMed  Google Scholar 

  37. Vishak S, Rohan V (2014) Cervical node metastasis in T1 squamous cell carcinoma of oral tongue-pattern and the predictive factors. Indian J Surg Oncol 5(2):104–108. doi:10.1007/s13193-014-0301-z

    Article  Google Scholar 

  38. Mucke T, Mitchell DA, Wagenpfeil S, Ritschl LM, Wolff KD, Kanatas A (2014) Incidence and outcome for patients with occult lymph node involvement in T1 and T2 oral squamous cell carcinoma: a prospective study. BMC Cancer 14:346. doi:10.1186/1471-2407-14-346

    Article  PubMed  PubMed Central  Google Scholar 

  39. Iype EM, Sebastian P, Mathew A, Balagopal PG, Varghese BT, Thomas S (2008) The role of selective neck dissection (I-III) in the treatment of node negative (N0) neck in oral cancer. Oral Oncol 44(12):1134–1138. doi:10.1016/j.oraloncology.2008.02.017

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

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

    K. Sagheb, V. Kumar, R. Rahimi-Nedjat, M. Dollhausen, T. Ziebart, B. Al-Nawas & C. Walter

  2. Department of Surgical Oncology-Head and Neck Surgery, Majumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bengaluru, India

    V. Kumar

Authors
  1. K. Sagheb
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Rahimi-Nedjat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Dollhausen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. Ziebart
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B. Al-Nawas
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C. Walter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K. Sagheb.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standard

A retrospective study was performed without any further consequences for the patient. According to this and the hospital laws of the individual states (Krankenhauslandesgesetz) no approval by the local ethics committee is necessary. The study was not sponsored.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sagheb, K., Kumar, V., Rahimi-Nedjat, R. et al. Cervical Metastases Behavior of T1–2 Squamous Cell Carcinoma of the Tongue. J. Maxillofac. Oral Surg. 16, 300–305 (2017). https://doi.org/10.1007/s12663-016-0936-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12663-016-0936-0

Keywords

Search

Navigation