Hoda Nadimul, Ghosh Mainak, Ganesan Aparna, Sabitha K S, Byadgi Akshay A, Amith K P
Department of Oral Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4455-4460. doi: 10.1007/s12070-024-04886-3. Epub 2024 Jul 16.
The implications of extranodal extension (ENE) in oral carcinoma have been often related to prognosis and survival rates. The clinicopathologic predictive factors of this established prognostic factor were analyzed in this retrospective study. A total of 358 medical records of a single institution were screened. Primary outcome variable was ENE. Predictor variables were clinical tumour (cT) and nodal (cN) staging, tumour subsite, and pathologically tumour size, depth of invasion (DOI), lymph node ratio (LNR), presence, or absence of perineural invasion (PNI), lymphovascular invasion (LVI) and mandibular involvement. After scrutinization, 216 records met the inclusion and exclusion criteria. Presence of ENE was noted in 42.1% (91/216) of patients. In cN0 necks ENE was 34.7% which was statistically significant. The cut-off value for tumour size, DOI and LNR were, 7.28 cm, 9 mm and 0.05 with accuracy rates of 68%, 79% and 94% respectively. The odds of presence ENE were highest with bone involvement (2.91) followed by PNI (2.34) and lastly LVI (2.17). In conclusion, these predictive factors can be used to fortify the pathologic diagnostic criteria of ENE.
The online version contains supplementary material available at 10.1007/s12070-024-04886-3.
口腔癌结外扩展(ENE)的影响通常与预后和生存率相关。在这项回顾性研究中分析了这一既定预后因素的临床病理预测因素。筛选了单一机构的358份病历。主要结局变量是ENE。预测变量包括临床肿瘤(cT)和淋巴结(cN)分期、肿瘤亚部位、以及病理肿瘤大小、浸润深度(DOI)、淋巴结比率(LNR)、是否存在神经周围浸润(PNI)、淋巴管浸润(LVI)和下颌骨受累情况。经过仔细审查,216份记录符合纳入和排除标准。42.1%(91/216)的患者存在ENE。在cN0颈部,ENE发生率为34.7%,具有统计学意义。肿瘤大小、DOI和LNR的截断值分别为7.28 cm、9 mm和0.05,准确率分别为68%、79%和94%。ENE存在的几率在骨受累时最高(2.91),其次是PNI(2.34),最后是LVI(2.17)。总之,这些预测因素可用于强化ENE的病理诊断标准。
在线版本包含可在10.1007/s12070-024-04886-3获取的补充材料。