ArticleCancer medicine2024
Prognostic Implications of the Number of Lymph Node Metastases in Oral Tongue Squamous Cell Carcinoma: A Population Study of the SEER Database and an Institutional Registry.
Article in Cancer medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Development and Validation of a Novel Pathologic Nodal Staging System for Oral Squamous Cell Carcinoma After Neoadjuvant Immunochemotherapy.Annals of surgical oncology · 2026Article
- Positron emission tomography/computed tomography radiomics-based prediction of cervical nodal metastasis in patients with tongue squamous cell carcinoma.Oral radiology · 2026Article
- Immunoexpression profile of LATS2 and YAP1 and its clinicopathological relevance in oral tongue squamous cell carcinoma.Oral and maxillofacial surgery · 2026Article
- Prognostic factors and cervical lymph node management in tongue squamous cell carcinoma: a retrospective cohort study.Clinical oral investigations · 2026Article
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12 authors.
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Abstract
backgroundTo investigate the impact of the number of positive lymph nodes (PLNs) on long-term survival and pathological nodal stage in patients with oral tongue squamous cell carcinoma (OTSCC). MATERIALS AND
methodsNewly diagnosed and nonmetastatic adult patients with OTSCC who underwent curative resection were identified between January 2010 and December 2020. External validation was performed via the SEER registry. Multivariate Cox proportional hazards model was employed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of pathological nodal features. Propensity score matching (PSM) was used to assess effect of adjuvant chemoradiotherapy (ACRT).
resultsAmong 518 curative-intent OTSCC patients, the number of PLNs independently predicted overall survival (OS), surpassing other pathological nodal features, including extranodal extension, laterality, and lower neck involvement. Patients with 1 or 2 PLNs had comparable worse OS than those with no PLN (median OS of 1 PLN vs. 2 PLNs vs. 0 PLN: 35.1 vs. 30.5 vs. 40.2 months), but better than those with ≥ 3 PLNs (median OS of 1-2 PLNs vs. 3 PLNs: 32.1 vs. 19.0 months). A proposed nodal category with 0, 1-2 PLNs, and ≥ 3 PLNs exhibited increasingly worse OS (HR of 1-2 PLNs and ≥ 3 PLNs vs. 0 PLN: 2.98 [95% CI: 1.89-4.71], p < 0.001; 5.47 [95% CI: 3.33-9], p < 0.001; respectively) and showed improved prediction power versus current pN staging (C-index: 0.717 vs. 0.713, p < 0.001). PSM analysis revealed that ACRT benefited patients with advanced nodal disease (≥ 3 PLNs) and improved OS. These findings were validated in SEER registry.
conclusionThe number of PLNs is a better predictor of overall tumor burden for OTSCC and could be a more accurate metric for survival estimation, which should be considered in future simplified pathological nodal staging for better risk stratification and decision-making in subsites of the oral cavity.
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