Evidence map›Paper›PMID 41838141›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

CT-defined posterior extension predicts pathological nodal metastasis in lower oral cavity squamous cell carcinoma.

Alberto Vito Marcuzzo, Rebecca De Colle, Ferruccio Degrassi, Simone Zucchini, Nicoletta Gardenal, Maria Assunta Cova, Giancarlo Tirelli

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Alberto Vito MarcuzzoDepartment of Medical, Surgical and Health Sciences, Section of Otolaringology, University of Trieste, Strada di Fiume 447, Trieste, 34149, Italy. avmarcuzzo@gmail.com.ORCID http://orcid.org/0000-0002-1340-9900
Rebecca De ColleDepartment of Medical, Surgical and Health Sciences, Section of Otolaringology, University of Trieste, Strada di Fiume 447, Trieste, 34149, Italy.
Ferruccio DegrassiDepartment of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Trieste, Italy.
Simone ZucchiniDepartment of Medical, Surgical and Health Sciences, Section of Otolaringology, University of Trieste, Strada di Fiume 447, Trieste, 34149, Italy.
Nicoletta GardenalDepartment of Medical, Surgical and Health Sciences, Section of Otolaringology, University of Trieste, Strada di Fiume 447, Trieste, 34149, Italy.
Maria Assunta CovaDepartment of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Trieste, Italy.
Giancarlo TirelliDepartment of Medical, Surgical and Health Sciences, Section of Otolaringology, University of Trieste, Strada di Fiume 447, Trieste, 34149, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnatomical tumor compartmentalization along the anteroposterior axis may influence metastatic behavior in lower oral cavity squamous cell carcinoma (LOCSCC). We developed a computed tomography (CT)-based classification of posterior tumor extension and evaluated its association with pathological nodal metastasis and survival outcomes.

methodsA retrospective cohort of 76 patients with surgically treated LOCSCC undergoing neck dissection was analyzed. Tumors located posterior to three reproducible CT reference lines were classified as posterior-to-posterior-most (PPP). Multivariable logistic regression assessed the independent association between PPP classification and pathological nodal metastasis (pN+), adjusting for depth of invasion (DOI). Cox proportional hazards models evaluated overall survival (OS) and disease-specific survival (DSS) adjusting for DOI and extranodal extension (ENE).

resultsPPP tumors accounted for 38.2% of cases and were strongly associated with nodal metastasis. On multivariable analysis (n = 64), PPP classification remained independently associated with pN+ (OR 24.98; 95% CI 4.75–131.37; p < 0.001). In survival analyses, ENE emerged as the strongest independent predictor of DSS (HR 6.23; p = 0.002), and DOI > 10 mm was also associated with worse DSS. PPP classification did not retain independent significance for OS or DSS after adjustment.

conclusionsCT-defined posterior extension represents a strong independent preoperative predictor of pathological nodal metastasis in LOCSCC. Although its impact on survival appears mediated by ENE and DOI, PPP classification may provide clinically relevant information for risk stratification, particularly in the management of the clinically N0 neck.

Indexed as

Carcinoma, Squamous CellLymph NodesMouth NeoplasmsTomography, X-Ray ComputedAgedFemaleHumansLymphatic MetastasisMaleMiddle AgedNeck DissectionNeoplasm StagingPrognosisRetrospective StudiesSurvival RateComputed tomographyNodal metastasisOral cavity squamous cell carcinomaRisk stratificationTumor compartmentalization

Identifiers

PMID41838141

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.