Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India.
Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India.
Laryngoscope. 2023 Mar;133(3):588-593. doi: 10.1002/lary.30158. Epub 2022 May 14.
Oral cancer portends a significant cause of morbidity and mortality worldwide. Cervical lymph node metastasis with extranodal extension (ENE) is associated with a poor prognosis. There has been accumulating evidence regarding the extent of ENE to be associated with prognosis and survival.
This observational study was performed to analyze the prognostic implication of macroscopic and microscopic ENE in metastatic cervical lymph nodes of oral cavity cancer patients.
A total of 92 oral cavity cancer patients with pathologically detected ENE were included in this study. Both the groups (macroscopic and microscopic ENE) were compared in terms of overall survival and disease-free survival by using Kaplan -Meier. The pattern of failure was determined by Fischer's exact test. Univariate and multivariate analyses were calculated to determine the significant risk factors of death.
The 2 years of disease-free survival and overall survival rates for the whole cohort were 51.2% and 53.9% respectively. The 2-year survival rate for the microscopic group (≤2 mm) and macroscopic (>2 mm) was 72.6% and 0% respectively, while the distal failure rate in microscopic ENE group and macroscopic ENE group was 22.22% and 44.83% respectively (p-value = 0.026).
Macroscopic ENE (>2 mm) in oral cavity squamous cell cancer represents an aggressive entity with early regional and distant failure as compared to microscopic ENE (≤2 mm). Thus, macroscopic ENE (>2 mm) warrants a distinct subgroup with special consideration for intensification of treatment.
3 Laryngoscope, 133:588-593, 2023.
口腔癌是全球发病率和死亡率较高的疾病之一。颈部淋巴结转移伴淋巴结外侵犯（ENE）与预后不良相关。目前已有大量证据表明，ENE 的程度与预后和生存相关。
本观察性研究旨在分析口腔癌颈部转移性淋巴结中宏观和微观 ENE 与预后的关系。
本研究共纳入 92 例经病理证实存在 ENE 的口腔癌患者。通过 Kaplan-Meier 法比较两组（宏观和微观 ENE）的总生存率和无病生存率。通过 Fisher 精确检验确定失败模式。通过单因素和多因素分析确定死亡的显著危险因素。
全队列的 2 年无病生存率和总生存率分别为 51.2%和 53.9%。微观组（≤2mm）和宏观组（>2mm）的 2 年生存率分别为 72.6%和 0%，而微观 ENE 组和宏观 ENE 组的远端失败率分别为 22.22%和 44.83%（p 值=0.026）。
与微观 ENE（≤2mm）相比，口腔鳞状细胞癌中的宏观 ENE（>2mm）代表一种侵袭性实体，具有早期区域和远处失败的风险。因此，宏观 ENE（>2mm）需要作为一个独特的亚组，特别考虑强化治疗。
3 级喉镜，133：588-593，2023。
