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- Title
Macroscopic and multiple metastases in sentinel lymph node biopsy are respectively associated with poor prognosis in early oral cancer.
- Authors
Kondo, Takahito; Tsukahara, Kiyoaki; Kawakita, Daisuke; Yoshimoto, Seiichi; Miura, Kouki; Sugasawa, Masashi; Chikamatsu, Kazuaki; Matsuzuka, Takashi; Oze, Isao; Kitamura, Morimasa; Murakami, Yoshiko; Otozai, Shinji; Shinozaki, Takeshi; Ohba, Shinichi; Araki, Koji; Mizumachi, Takatsugu; Sato, Dai; Wakisaka, Naohiro; Hirakawa, Hitoshi; Hasegawa, Yasuhisa
- Abstract
Background: A multicenter, randomized controlled phase III trial was conducted on sentinel lymph node biopsy (SLNB) and elective neck dissection for T1 (depth of invasion ≥ 4 mm)–T2N0M0 oral cavity squamous cell carcinoma. This study identified factors associated with poor prognosis in patients who underwent SLNB based on a subgroup analysis of this trial. Methods: We analyzed 418 sentinel lymph nodes (SLNs) from 132 patients who underwent SLNB. The metastatic SLNs were classified into three categories based on size-isolated tumor cells: < 0.2 mm, micrometastasis: ≥ 0.2 mm and < 2 mm, and macrometastasis: ≥ 2 mm. Three groups were formed based on the number of metastatic SLNs: no metastasis, 1 metastatic node, and ≥ 2 metastatic nodes. The size and number of metastatic SLNs on survival were evaluated using Cox proportional hazard models. Results: Patients with macrometastasis and ≥ 2 metastatic SLNs had worse overall survival (OS) and disease-free survival (DFS) after adjustment for potential confounders (HR for OS: macrometastasis, 4.85; 95% CI 1.34–17.60; ≥ 2 metastatic SLN, 3.63; 95% CI 1.02–12.89; HR for DFS: macrometastasis, 2.94; 95% CI 1.16–7.44; ≥ 2 metastatic SLN, 2.97; 95% CI 1.18–7.51). Conclusions: In patients who underwent SLNB, a poorer prognosis was associated with macrometastasis or having ≥ 2 metastatic SLNs.
- Subjects
SENTINEL lymph node biopsy; MICROMETASTASIS; LYMPHATIC metastasis; ORAL cancer; SENTINEL lymph nodes; CLINICAL trials
- Publication
International Journal of Clinical Oncology, 2023, Vol 28, Issue 4, p512
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-023-02305-1