Abstract：
OBJECTIVE: Whereas the prevalence of lymph node level (LNL) involvement in oral cavity squamous cell carcinomas (OCSCC) has been reported, the details of lymphatic progression patterns are insufficiently quantified. We investigate how the risk of metastases in each LNL depends on the involvement of adjacent LNLs, T-category, subsite, primary tumor lateralization, and other risk factors.
METHODS: We retrospectively analyzed patients with newly diagnosed OCSCC from two institutions, totaling 348 patients. Involvement of LNLs I-V was recorded individually based on pathology after neck dissection with clinicopathological factors. The dataset is publicly available in a previously developed web-app, which allows querying patients with specific combinations of co-involved LNLs and tumor characteristics.
RESULTS: Ipsilateral involvement prevalence of levels I-III was higher for advanced T-category (T3/T4) patients (32 %, 38 %, 14 %) compared to early (T1/T2) patients (14 %, 23 %, 11 %). Involvement of level I increased the involvement probability in levels II and III. Similarly, involvement of level II increased the involvement probability in levels I and III. However, there was significant isolated involvement of level I or II. Advanced nodal involvement (>1 LNL involved) was more frequent for patients with extracapsular extension. Overall contralateral involvement in levels I-III was 7 %, 4 %, 3 % and more frequent for more advanced ipsilateral involvement and for midline-crossing tumors. Involvement of levels IV and V was rare: 3 % ipsilateral and 1 % contralateral in both levels.
CONCLUSIONS: Detailed quantification of LNL involvement in OCSCC depending on involvement of adjacent LNLs and clinicopathological factors may allow further personalizing guidelines on elective nodal treatment.
METHODS: We retrospectively analyzed patients with newly diagnosed OCSCC from two institutions, totaling 348 patients. Involvement of LNLs I-V was recorded individually based on pathology after neck dissection with clinicopathological factors. The dataset is publicly available in a previously developed web-app, which allows querying patients with specific combinations of co-involved LNLs and tumor characteristics.
RESULTS: Ipsilateral involvement prevalence of levels I-III was higher for advanced T-category (T3/T4) patients (32 %, 38 %, 14 %) compared to early (T1/T2) patients (14 %, 23 %, 11 %). Involvement of level I increased the involvement probability in levels II and III. Similarly, involvement of level II increased the involvement probability in levels I and III. However, there was significant isolated involvement of level I or II. Advanced nodal involvement (>1 LNL involved) was more frequent for patients with extracapsular extension. Overall contralateral involvement in levels I-III was 7 %, 4 %, 3 % and more frequent for more advanced ipsilateral involvement and for midline-crossing tumors. Involvement of levels IV and V was rare: 3 % ipsilateral and 1 % contralateral in both levels.
CONCLUSIONS: Detailed quantification of LNL involvement in OCSCC depending on involvement of adjacent LNLs and clinicopathological factors may allow further personalizing guidelines on elective nodal treatment.
摘要：
目的：尽管口腔鳞状细胞癌（OCSCC）中淋巴结水平（LNL）的患病率已有报道，淋巴进展模式的细节量化不足.我们调查了每个LNL的转移风险如何取决于相邻LNL的受累情况，T类,subsite,原发性肿瘤侧化，和其他风险因素。
方法：我们回顾性分析了来自两个机构的新诊断OCSCC患者，共348名患者。根据颈淋巴结清扫术后病理和临床病理因素，分别记录LNLsI-V的参与情况。该数据集在以前开发的Web应用程序中公开可用，这允许查询具有共同参与的LNLs和肿瘤特征的特定组合的患者。
结果：晚期T类（T3/T4）患者的I-III级同侧受累率较高（32％，38%,14%)与早期(T1/T2)患者(14%,23%,11%）。I级的参与增加了II级和III级的参与概率。同样，II级的参与增加了I级和III级的参与概率.然而,有显著的I级或II级孤立参与.对于囊外延伸的患者，晚期淋巴结受累（>1LNL受累）更为常见。I-III级对侧总体受累为7%，4%,3％，对于更晚期的同侧受累和中线交叉肿瘤，频率更高。IV和V级的参与很少见：在两个级别中，同侧为3％，对侧为1％。
结论：根据邻近LNL的受累情况和临床病理因素，对OCSCC中LNL受累情况进行详细量化，可能允许进一步对选择性淋巴结治疗进行个性化指导。
方法：我们回顾性分析了来自两个机构的新诊断OCSCC患者，共348名患者。根据颈淋巴结清扫术后病理和临床病理因素，分别记录LNLsI-V的参与情况。该数据集在以前开发的Web应用程序中公开可用，这允许查询具有共同参与的LNLs和肿瘤特征的特定组合的患者。
结果：晚期T类（T3/T4）患者的I-III级同侧受累率较高（32％，38%,14%)与早期(T1/T2)患者(14%,23%,11%）。I级的参与增加了II级和III级的参与概率。同样，II级的参与增加了I级和III级的参与概率.然而,有显著的I级或II级孤立参与.对于囊外延伸的患者，晚期淋巴结受累（>1LNL受累）更为常见。I-III级对侧总体受累为7%，4%,3％，对于更晚期的同侧受累和中线交叉肿瘤，频率更高。IV和V级的参与很少见：在两个级别中，同侧为3％，对侧为1％。
结论：根据邻近LNL的受累情况和临床病理因素，对OCSCC中LNL受累情况进行详细量化，可能允许进一步对选择性淋巴结治疗进行个性化指导。
