Abstract：
Whereas the prevalence of lymph node level (LNL) involvement in head & neck squamous cell carcinomas (HNSCC) has been reported, the details of lymphatic progression patterns are insufficiently quantified. In this study, we investigate how the risk of metastases in each LNL depends on the involvement of upstream LNLs, T-category, HPV status and other risk factors.
We retrospectively analyzed patients with newly diagnosed oropharyngeal squamous cell carcinoma (OPSCC) treated at a single institution, resulting in a dataset of 287 patients. For all patients, involvement of LNLs I-VII was recorded individually based on available diagnostic modalities (PET, MRI, CT, FNA) together with clinicopathological factors. To analyze the dataset, a web-based graphical user interface (GUI) was developed, which allows querying the number of patients with a certain combination of co-involved LNLs and tumor characteristics.
The full dataset and GUI is part of the publication. Selected findings are: Ipsilateral level IV was involved in 27% of patients with level II and III involvement, but only in 2% of patients with level II but not III involvement. Prevalence of involvement of ipsilateral levels II, III, IV, V was 79%, 34%, 7%, 3% for early T-category patients (T1/T2) and 85%, 50%, 17%, 9% for late T-category (T3/T4), quantifying increasing involvement with T-category. Contralateral levels II, III, IV were involved in 41%, 19%, 4% and 12%, 3%, 2% for tumors with and without midline extension, respectively. T-stage dependence of LNL involvement was more pronounced in HPV negative than positive tumors, but overall involvement was similar. Ipsilateral level VII was involved in 14% and 6% of patients with primary tumors in the tonsil and the base of tongue, respectively.
Detailed quantification of LNL involvement in HNSCC depending on involvement of upstream LNLs and clinicopathological factors may allow for further personalization of CTV-N definition in the future.
We retrospectively analyzed patients with newly diagnosed oropharyngeal squamous cell carcinoma (OPSCC) treated at a single institution, resulting in a dataset of 287 patients. For all patients, involvement of LNLs I-VII was recorded individually based on available diagnostic modalities (PET, MRI, CT, FNA) together with clinicopathological factors. To analyze the dataset, a web-based graphical user interface (GUI) was developed, which allows querying the number of patients with a certain combination of co-involved LNLs and tumor characteristics.
The full dataset and GUI is part of the publication. Selected findings are: Ipsilateral level IV was involved in 27% of patients with level II and III involvement, but only in 2% of patients with level II but not III involvement. Prevalence of involvement of ipsilateral levels II, III, IV, V was 79%, 34%, 7%, 3% for early T-category patients (T1/T2) and 85%, 50%, 17%, 9% for late T-category (T3/T4), quantifying increasing involvement with T-category. Contralateral levels II, III, IV were involved in 41%, 19%, 4% and 12%, 3%, 2% for tumors with and without midline extension, respectively. T-stage dependence of LNL involvement was more pronounced in HPV negative than positive tumors, but overall involvement was similar. Ipsilateral level VII was involved in 14% and 6% of patients with primary tumors in the tonsil and the base of tongue, respectively.
Detailed quantification of LNL involvement in HNSCC depending on involvement of upstream LNLs and clinicopathological factors may allow for further personalization of CTV-N definition in the future.
摘要：
尽管已经报道了头颈部鳞状细胞癌（HNSCC）中淋巴结水平（LNL）的患病率，淋巴进展模式的细节量化不足.在这项研究中,我们调查每个LNL的转移风险如何取决于上游LNL的参与，T类,HPV状态和其他危险因素。
我们回顾性分析了在单一机构治疗的新诊断口咽鳞状细胞癌（OPSCC）患者，产生了287名患者的数据集。对于所有患者来说，根据可用的诊断方式单独记录LNLsI-VII的受累情况(PET，MRI,CT,FNA）与临床病理因素。要分析数据集，开发了基于网络的图形用户界面(GUI)，这允许查询具有共同涉及的LNLs和肿瘤特征的特定组合的患者数量。
完整的数据集和GUI是发布的一部分。所选择的结果是：在II级和III级受累的患者中，同侧IV级受累的患者占27％，但仅在2％的II级而非III级患者中。同侧II级受累的患病率，III,IV,V为79%，34%,7%,3％为早期T类患者（T1/T2）和85％，50%,17%,晚期T类（T3/T4）为9%，量化与T类别的日益增加的参与。对侧水平II，III,IV参与了41%，19%,4%和12%，3%,有和没有中线延伸的肿瘤为2%，分别。在HPV阴性的肿瘤中，LNL受累的T期依赖性比阳性的肿瘤更明显，但总体参与情况相似。14％和6％的扁桃体和舌根原发性肿瘤患者涉及同侧VII级，分别。
根据上游LNL的受累情况和临床病理因素，对HNSCC中LNL的受累情况进行详细量化，可以在未来进一步个性化CTV-N定义。
我们回顾性分析了在单一机构治疗的新诊断口咽鳞状细胞癌（OPSCC）患者，产生了287名患者的数据集。对于所有患者来说，根据可用的诊断方式单独记录LNLsI-VII的受累情况(PET，MRI,CT,FNA）与临床病理因素。要分析数据集，开发了基于网络的图形用户界面(GUI)，这允许查询具有共同涉及的LNLs和肿瘤特征的特定组合的患者数量。
完整的数据集和GUI是发布的一部分。所选择的结果是：在II级和III级受累的患者中，同侧IV级受累的患者占27％，但仅在2％的II级而非III级患者中。同侧II级受累的患病率，III,IV,V为79%，34%,7%,3％为早期T类患者（T1/T2）和85％，50%,17%,晚期T类（T3/T4）为9%，量化与T类别的日益增加的参与。对侧水平II，III,IV参与了41%，19%,4%和12%，3%,有和没有中线延伸的肿瘤为2%，分别。在HPV阴性的肿瘤中，LNL受累的T期依赖性比阳性的肿瘤更明显，但总体参与情况相似。14％和6％的扁桃体和舌根原发性肿瘤患者涉及同侧VII级，分别。
根据上游LNL的受累情况和临床病理因素，对HNSCC中LNL的受累情况进行详细量化，可以在未来进一步个性化CTV-N定义。
