Division of Health Science, Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
Division of Oral Health Science, Department of Oral Radiation Oncology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, 113-8549, Japan.
Sci Rep. 2021 Oct 15;11(1):20535. doi: 10.1038/s41598-021-99925-2.
Squamous cell carcinoma (SCC) of the tongue rarely metastasizes to the lingual lymph nodes (LLNs), which are inconstant nodes and often situated outside the areas of basic tongue tumor surgery. The current study evaluated the clinicopathological features and prognostic impact of LLN metastasis (LLNM), compared to that of cervical lymph node metastasis, in patients with tongue SCC. A total of 608 patients underwent radical surgery for tongue SCC at our department between January 2001 and December 2016. During neck dissection, we scrutinized and resected lateral LLNs, when present. Of the 128 patients with lymph node metastasis, 107 had cervical lymph node metastasis and 21 had both cervical lymph node metastasis and LLNM. Univariate analysis demonstrated that LLNM was significantly associated with the adverse features of cervical lymph node metastasis. The 5-year disease-specific survival (5y-DSS) was significantly lower in patients with LLNMs than in those without LLNMs (49.0% vs. 88.4%, P < 0.01). Moreover, Cox proportional hazards model analyses revealed that cervical lymph node metastasis at level IV or V and LLNM were independent prognostic factors for 5y-DSS. LLNM has a strong negative impact on survival in patients with tongue SCC. An advanced status of cervical lymph node metastasis may predict LLNM.
舌鳞状细胞癌 (SCC) 很少转移到舌淋巴结 (LLN)，这些淋巴结不恒定，通常位于基本舌肿瘤手术区域之外。本研究评估了 LLN 转移 (LLNM) 的临床病理特征和预后影响，并与舌 SCC 患者的颈淋巴结转移进行了比较。2001 年 1 月至 2016 年 12 月期间，共有 608 例患者在我科接受根治性舌 SCC 手术。在颈清扫术中，当存在外侧 LLN 时，我们仔细检查并切除。在 128 例淋巴结转移患者中，107 例有颈淋巴结转移，21 例有颈淋巴结转移和 LLNM。单因素分析表明，LLNM 与颈淋巴结转移的不良特征显著相关。有 LLNM 的患者 5 年疾病特异性生存率 (5y-DSS) 明显低于无 LLNM 的患者 (49.0%比 88.4%，P<0.01)。此外，Cox 比例风险模型分析显示，IV 或 V 级颈淋巴结转移和 LLNM 是 5y-DSS 的独立预后因素。LLNM 对舌 SCC 患者的生存有强烈的负面影响。颈淋巴结转移的晚期状态可能预示着 LLNM。
