Study on LevelⅣmetastasis risk factor of oral squamous cell car-cinoma patients / 中国肿瘤临床

ABSTRACT

Objective:To investigate the Level Ⅳ metastasis risk factor of oral cancer patient's ipsilateral neck. Methods:The medical records of 624 cases (644 sides of the neck) that underwent neck dissection at the time of primary surgery for oral carcinoma were included. Chi-square test and logistic regression analysis were performed to determine the factors associated with LevelⅣmetas-tasis. Results:Out of 334 cases (345 neck sides) with positive lymph nodes, only 35 sides (5.43%, 35/644) showed LevelⅢinvolve-ment and only 4 sides (0.62%, 4/644) developed skip metastasis (LevelⅢ). The metastatic rate of LevelⅣwas 1.31%(4/303) for pN-LevelsⅠ-Ⅲnecks and 9.14%(31/341) for pN+LevelsⅠ-Ⅲnecks. Using Chi-square test, pN+LevelsⅠ-Ⅲlymph node metastases were associated with the LevelⅣnodal metastases. For necks with pN+LevelⅢ, with three positive Levels among LevelsⅠ-Ⅲ, and with positive lymph node≥3 among LevelsⅠ-Ⅲ, the LevelⅣmetastasis rates were 22.47%(20/89), 28.57%(10/35), and 14.60%(20/137), respectively. Furthermore, logistic regression was applied to identify the relationship between the metastasis situation of the afore-mentioned three Levels and LevelⅣ. Three positive Levels among LevelsⅠ-Ⅲ(pN+LevelⅠ+pN+LevelⅡ+pN+LevelⅢ) were confirmed to correlate with the presence of the positive lymph nodes in LevelⅣ. Conclusion:In oral cancer patients, LevelsⅠ-Ⅲmetastaces will increase the risk of LevelⅣmetastasis.