The relationship between clinical and histological factors and prognosis was investigated retrospectively in 60 patients with squamous cell carcinoma of the oral cavity encountered in our clinic during the post 6 years from 1983 to 1988.
The subjects were classified into three groups, no metastatic group;metastasis was not recognized within a year after primary treatment, primary metastatic group; metastasis was recognized at first examination, secondary metastatic group;metastasis was recognized after the primary treatment.
We performed a comparative study in these three groups especially on the clinical and histological factors.Clinically, we evaluated the tumor size according to the TNM classification of UICC (1987). Histologically, we evaluated the tumor cell population factors (differentiation, nuclear polymorphism and mitosis) according to the classification of WHO and Hanazawa and investigated the histological factors (tumor-host relationship), mode of invasion, stage of invasion and cellular response according to the classification of Yamamoto and Willen.
The following results were obtained:
1) The relationship between the size of primary lesion and cervical lymph node metastasis was suggested.
2) The relationship between the mode of invasion and cervical lymph node metastasis was suggested.
3) The relationship between cellular response (cellular reaction against tumor) and cervical lymph node metastasis was suggested.
4) The relationship between the stage of invasion and cervical lymph node metastasis was suggested.
5) The primary tumor with cervical lymph node metastasis mostly distributed in the cases of M or more for the mode of invasion and T2 or more for the tumor size of primary lesion.
6) No distinct relationship was observed between cellular malignancy and cervical lymph node metastasis.
7) The primary tumor with cervical lymph node metastasis was mainly distributed in the cases with total histological malignancy score of 9 or more.
8) These findings suggest that histological malignancy of the tumor and host cellular reaction against the tumor are more important factors than cellular malignancy of the tumor its, lf when cervical lymph node metastasis is evaluated.
