Division of Otolaryngology, Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT 06510, USA.
Am J Clin Oncol. 2012 Oct;35(5):468-73. doi: 10.1097/COC.0b013e3182195619.
To examine the importance of midline involvement and other clinicopathologic factors in predicting the rate of contralateral lymph node metastasis and survival in oral tongue squamous cell carcinoma.
We used Surveillance, Epidemiology, and End Results data to identify a cohort of 5430 patients with laterally rising tumors. Clinicopathologic factors examined as potentially predictive of contralateral lymph node metastasis included extension to midline, T classification, anatomic site, grade, histologic subtype, race, age, and sex. Survival analysis included the above factors plus lymph node status.
T1 tumors and lateral T2 and T3 tumors had rates of contralateral lymph node metastasis ranging from 0.7% to 0.9% on presentation. T4 lesions and midline crossing T2 and T3 lesions had corresponding rates of 8.3% to 13.0%. Primary extension across the midline was associated with a mean survival about half that of strictly lateral tumors and its significance was maintained in multivariate analysis.
Patients with T1 disease or T2-3 disease that does not cross midline are in a different prognostic class from patients with T2-3 disease that crosses midline or T4 tumors. These results give the strongest evidence to date that involvement of the midline is a powerful predictor for decreased survival in oral tongue squamous cell carcinoma.
探讨中线侵犯及其他临床病理因素在预测口腔舌鳞状细胞癌对侧淋巴结转移率和生存率中的重要性。
我们使用监测、流行病学和最终结果数据，确定了 5430 例侧向上升肿瘤患者的队列。作为预测对侧淋巴结转移的潜在预测因素的临床病理因素包括延伸至中线、T 分类、解剖部位、分级、组织学亚型、种族、年龄和性别。生存分析包括上述因素加淋巴结状态。
T1 肿瘤和外侧 T2 和 T3 肿瘤在出现时对侧淋巴结转移率为 0.7%至 0.9%。T4 病变和中线交叉 T2 和 T3 病变的相应比率为 8.3%至 13.0%。原发肿瘤横跨中线的延伸与平均生存率约为严格侧向肿瘤的一半，并且在多变量分析中保持其意义。
T1 疾病或不跨越中线的 T2-3 疾病患者与跨越中线或 T4 肿瘤的 T2-3 疾病患者处于不同的预后类别。这些结果提供了迄今为止最强的证据，表明中线侵犯是口腔舌鳞状细胞癌生存率降低的有力预测指标。
