Cancer Res Treat.  2016 Jan;48(1):54-62. 10.4143/crt.2014.332.

Prediction of Lymph Node Metastasis by Tumor Dimension Versus Tumor Biological Properties in Head and Neck Squamous Cell Carcinomas

• Jang JY
• Kim MJ
• Ryu G
• Choi N
• Ko YH
• Jeong HS

• KMID: 2152260
• DOI: http://doi.org/10.4143/crt.2014.332

Abstract

PURPOSE
Lymph node metastasis (LNM) is a strong prognostic factor in many solid cancers, including head and neck squamous cell carcinomas (HNSCC), and LNM can be dependent upon primary tumor biology, as well as tumor dimension. Here, we investigate the relative risk of LNM in accordance to tumor dimension and biology in HNSCC subsites.
MATERIALS AND METHODS
Medical data of 295 HNSCC patients who had undergone the initial curative surgery (oral tongue 174, oropharynx 75, hypopharynx 46) were analyzed to identify the significant predictive factor for LNM. Tumor volume and thickness were set as tumor dimensional variables, and biological variables included lymphovascular, perineural invasion, and tumor differentiation. Statistical analyses were conducted to assess the predictability of LNM from variables, and subgroup analyses according to the tumor subsites. In addition, we evaluated the impacts of tumor dimension and biological variables on the treatment outcomes and survival in HNSCC subsites.
RESULTS
The overall tumor dimension and biological variables had a similar impact on the prediction of LNM in HNSCC (area under the curve, 0.7682 and 0.7717). The prediction sensitivity of LNM in oral tongue cancer was mainly dependent on tumor dimension, while LNM in oroand hypo-pharynx cancers was more influenced by biological factors. Survival analyses also confirmed that biological factor was more powerful in estimating disease-free survival of hypopharyngeal cancer patients, while tumor dimension was more significant in that of oral cancer patients.
CONCLUSION
Tumor dimension and biology have a significant, tumor subsite-dependent impact on the occurrence of LNM and disease-free survival in HNSCC.

Keyword

Lymphatic metastasis; Head and neck neoplasms; Tumor burden; Tumor biological markers; Neoplasm metastasis

MeSH Terms

Biological Factors
Biology
Carcinoma, Squamous Cell*
Disease-Free Survival
Head and Neck Neoplasms
Head*
Humans
Hypopharyngeal Neoplasms
Hypopharynx
Lymph Nodes*
Lymphatic Metastasis
Mouth Neoplasms
Neck*
Neoplasm Metastasis*
Oropharynx
Tongue
Tongue Neoplasms
Tumor Burden
Biological Factors

Figure

• 

  Fig. 1. Receiver operating characteristics (ROC) curve analyses to estimate predictability for lymph node metastasis by tumor dimension and biology variables. ROC curve from tumor dimensional variables (A), tumor biological variables (B), and combined measure of tumor dimensional and biological variables (C). AUC, area under the curves.

• 

  Fig. 2. Predictability for lymph node metastasis according to the tumor subsites. Receiver operating characteristics curve from oral tongue cancer (A), oropharynx cancer (B), and hypopharynx cancer (C). AUC, area under the curves.

Reference

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