A multicenter retrospective study of the clinical outcomes of patients with delayed cervical lymph node metastasis in stage I-II squamous cell carcinoma of the oral cavity

Abstract

To evaluate the clinical outcomes of patients with delayed cervical lymph node metastasis in stage I-II squamous cell carcinoma (SCC) of the oral cavity, we performed a multicenter retrospective study. We analyzed the records of 141 patients with delayed cervical lymph node metastasis admitted to hospitals between 2002 and 2011. Survival rates of the subjects were compared with those of 27 patients who underwent elective neck dissection (END).
The 5-year cumulative disease-specific survival and overall survival rates were 75.7% and 68.9%, respectively. In patients with delayed cervical lymph node metastasis, radical neck dissection or modified radical neck dissection should be performed. Univariate and multivariate analyses showed that variables independently prognostic for survival were multiple nodal metastases, ipsilateral lower neck metastasis (level IV/V), and extracapsular spread. In patients with these prognostic factors, postoperative adjuvant therapy should be performed. Because there is little difference between the wait-and-see policy and END, we believe that END is unnecessary if there is strict follow-up observation. However, to further improve the survival of stage I-II SCC of the oral cavity, it is necessary to elucidate the predictive factors for occult metastasis and conduct a large prospective clinical trial.