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Erschienen in: Virchows Archiv 5/2018

09.04.2018 | Original Article

Postoperative radiotherapy is dispensable for OSCC patients with micrometastases in lymph nodes

verfasst von: Y. M. Pu, Y. Yang, Y. J. Wang, L. Ding, X. F. Huang, Z. Y. Wang, Y. H. Ni, Q. G. Hu

Erschienen in: Virchows Archiv | Ausgabe 5/2018

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Abstract

Lymph node metastasis is a decisive factor for performing postoperative radiotherapy for oral squamous cell carcinoma (OSCC). However, whether OSCC patients with only micrometastasis need postoperative radiotherapy is unclear. In this study, OSCC patients (n = 311) with negative (n = 247), only micrometastasis (n = 44) and macrometastasis (n = 20) were detected and selected by HE staining. Micrometastasis was re-assessed using immunohistochemical staining of cytokeratin (CK) in HE-negative patients to find out the false negative cases. The results indicated that, among the negative lymph node cases (n = 247), the positive rate of CK was 4.94% (n = 12). Besides, the clinical features of the primary tumor in relation to the only micrometastatic status and the value of the postoperative radiotherapy on the only micrometastasis patients were evaluated. Patients with only micrometastasis had higher T stage and inferior worst pattern of invasion (WPOI) than patients without micrometastasis, but they had longer overall survival (OS), metastasis-free survival (MFS), and disease-free survival (DFS) than macrometastasis patients. However, the survival time of only micrometastasis patients with or without postoperative radiotherapy was comparable, even in patients with inferior WPOI. Radiotherapy, however, may only benefit patients with IV/V levels of micrometastasis. These data indicated that postoperative radiotherapy is dispensable for only micrometastasis OSCC patients.
Literatur
1.
Zurück zum Zitat Cunningham MJ, Johnson JT, Myers EN, Schramm VL Jr, Thearle PB (1986) Cervical lymph node metastasis after local excision of early squamous cell carcinoma of the oral cavity. Am J Surg 152(4):361–366CrossRefPubMed Cunningham MJ, Johnson JT, Myers EN, Schramm VL Jr, Thearle PB (1986) Cervical lymph node metastasis after local excision of early squamous cell carcinoma of the oral cavity. Am J Surg 152(4):361–366CrossRefPubMed
2.
Zurück zum Zitat Woolgar JA (1997) Detailed topography of cervical lymph-note metastases from oral squamous cell carcinoma. Int J Oral Maxillofac Surg 26(1):3–9CrossRefPubMed Woolgar JA (1997) Detailed topography of cervical lymph-note metastases from oral squamous cell carcinoma. Int J Oral Maxillofac Surg 26(1):3–9CrossRefPubMed
3.
Zurück zum Zitat den Brekel MW, Stel HV, van der Valk P, van der Waal I, Meyer CJ, Snow GB (1992) Micrometastases from squamous cell carcinoma in neck dissection specimens. Eur Arch Otorhinolaryngol 249(6):349–353CrossRefPubMed den Brekel MW, Stel HV, van der Valk P, van der Waal I, Meyer CJ, Snow GB (1992) Micrometastases from squamous cell carcinoma in neck dissection specimens. Eur Arch Otorhinolaryngol 249(6):349–353CrossRefPubMed
5.
Zurück zum Zitat Hamakawa H, Takemura K, Sumida T, Kayahara H, Tanioka H, Sogawa K (2000) Histological study on pN upgrading of oral cancer. Virchows Arch 437(2):116–121CrossRefPubMed Hamakawa H, Takemura K, Sumida T, Kayahara H, Tanioka H, Sogawa K (2000) Histological study on pN upgrading of oral cancer. Virchows Arch 437(2):116–121CrossRefPubMed
11.
Zurück zum Zitat Brandwein-Gensler M, Teixeira MS, Lewis CM, Lee B, Rolnitzky L, Hille JJ, Genden E, Urken ML, Wang BY (2005) Oral squamous cell carcinoma: histologic risk assessment, but not margin status, is strongly predictive of local disease-free and overall survival. Am J Surg Pathol 29(2):167–178CrossRefPubMed Brandwein-Gensler M, Teixeira MS, Lewis CM, Lee B, Rolnitzky L, Hille JJ, Genden E, Urken ML, Wang BY (2005) Oral squamous cell carcinoma: histologic risk assessment, but not margin status, is strongly predictive of local disease-free and overall survival. Am J Surg Pathol 29(2):167–178CrossRefPubMed
13.
Zurück zum Zitat Velosa C, Shi Q, Stevens TM, Chiosea SI, Purgina B, Carroll W, Rosenthal E, Morlandt A, Loree T, Brandwein-Weber MS (2017) Worst pattern of invasion and occult cervical metastases for oral squamous carcinoma. Head Neck. https://doi.org/10.1002/hed.24754 Velosa C, Shi Q, Stevens TM, Chiosea SI, Purgina B, Carroll W, Rosenthal E, Morlandt A, Loree T, Brandwein-Weber MS (2017) Worst pattern of invasion and occult cervical metastases for oral squamous carcinoma. Head Neck. https://​doi.​org/​10.​1002/​hed.​24754
15.
Zurück zum Zitat Hermanek P, Hutter RV, Sobin LH, Wittekind C (1999) International Union Against Cancer. Classification of isolated tumor cells and micrometastasis. Cancer 86(12):2668–2673CrossRefPubMed Hermanek P, Hutter RV, Sobin LH, Wittekind C (1999) International Union Against Cancer. Classification of isolated tumor cells and micrometastasis. Cancer 86(12):2668–2673CrossRefPubMed
16.
Zurück zum Zitat Genden EM, Ferlito A, Bradley PJ, Rinaldo A, Scully C (2003) Neck disease and distant metastases. Oral Oncol 39(3):207–212CrossRefPubMed Genden EM, Ferlito A, Bradley PJ, Rinaldo A, Scully C (2003) Neck disease and distant metastases. Oral Oncol 39(3):207–212CrossRefPubMed
18.
Zurück zum Zitat Ferlito A, Partridge M, Brennan J, Hamakawa H (2001) Lymph node micrometastases in head and neck cancer: a review. Acta Otolaryngol 121(6):660–665CrossRefPubMed Ferlito A, Partridge M, Brennan J, Hamakawa H (2001) Lymph node micrometastases in head and neck cancer: a review. Acta Otolaryngol 121(6):660–665CrossRefPubMed
19.
Zurück zum Zitat Ferlito A, Shaha AR, Rinaldo A (2002) The incidence of lymph node micrometastases in patients pathologically staged N0 in cancer of oral cavity and oropharynx. Oral Oncol 38(1):3–5CrossRefPubMed Ferlito A, Shaha AR, Rinaldo A (2002) The incidence of lymph node micrometastases in patients pathologically staged N0 in cancer of oral cavity and oropharynx. Oral Oncol 38(1):3–5CrossRefPubMed
21.
Zurück zum Zitat Ambrosch P, Kron M, Fischer G, Brinck U (1995) Micrometastases in carcinoma of the upper aerodigestive tract: detection, risk of metastasizing, and prognostic value of depth of invasion. Head Neck 17(6):473–479CrossRefPubMed Ambrosch P, Kron M, Fischer G, Brinck U (1995) Micrometastases in carcinoma of the upper aerodigestive tract: detection, risk of metastasizing, and prognostic value of depth of invasion. Head Neck 17(6):473–479CrossRefPubMed
24.
Zurück zum Zitat Glickman JN, Torres C, Wang HH, Turner JR, Shahsafaei A, Richards WG, Sugarbaker DJ, Odze RD (1999) The prognostic significance of lymph node micrometastasis in patients with esophageal carcinoma. Cancer 85(4):769–778CrossRefPubMed Glickman JN, Torres C, Wang HH, Turner JR, Shahsafaei A, Richards WG, Sugarbaker DJ, Odze RD (1999) The prognostic significance of lymph node micrometastasis in patients with esophageal carcinoma. Cancer 85(4):769–778CrossRefPubMed
25.
Zurück zum Zitat Nieuwenhuis EJ, Leemans CR, Kummer JA, Denkers F, Snow GB, Brakenhoff RH (2003) Assessment and clinical significance of micrometastases in lymph nodes of head and neck cancer patients detected by E48 (Ly-6D) quantitative reverse transcription-polymerase chain reaction. Lab Invest 83(8):1233–1240CrossRefPubMed Nieuwenhuis EJ, Leemans CR, Kummer JA, Denkers F, Snow GB, Brakenhoff RH (2003) Assessment and clinical significance of micrometastases in lymph nodes of head and neck cancer patients detected by E48 (Ly-6D) quantitative reverse transcription-polymerase chain reaction. Lab Invest 83(8):1233–1240CrossRefPubMed
26.
Zurück zum Zitat Bryne M, Koppang HS, Lilleng R, Stene T, Bang G, Dabelsteen E (1989) New malignancy grading is a better prognostic indicator than Broders’ grading in oral squamous cell carcinomas. J Oral Pathol Med 18(8):432–437CrossRefPubMed Bryne M, Koppang HS, Lilleng R, Stene T, Bang G, Dabelsteen E (1989) New malignancy grading is a better prognostic indicator than Broders’ grading in oral squamous cell carcinomas. J Oral Pathol Med 18(8):432–437CrossRefPubMed
27.
Zurück zum Zitat Min KW, Houck JR Jr (1998) Protocol for the examination of specimens removed from patients with carcinomas of the upper aerodigestive tract: carcinomas of the oral cavity including lip and tongue, nasal and paranasal sinuses, pharynx, larynx, salivary glands, hypopharynx, oropharynx, and nasopharynx. Cancer Committee, College of American Pathologists. Arch Pathol Lab Med 122(3):222–230PubMed Min KW, Houck JR Jr (1998) Protocol for the examination of specimens removed from patients with carcinomas of the upper aerodigestive tract: carcinomas of the oral cavity including lip and tongue, nasal and paranasal sinuses, pharynx, larynx, salivary glands, hypopharynx, oropharynx, and nasopharynx. Cancer Committee, College of American Pathologists. Arch Pathol Lab Med 122(3):222–230PubMed
28.
Zurück zum Zitat Carrau RL, Barnes EL, Snyderman CH, Petruzzelli G, Kachman K, Rueger R, D’Amico F, Johnson JT (1995) Tumor angiogenesis as a predictor of tumor aggressiveness and metastatic potential in squamous cell carcinoma of the head and neck. Invasion Metastasis 15(5–6):197–202PubMed Carrau RL, Barnes EL, Snyderman CH, Petruzzelli G, Kachman K, Rueger R, D’Amico F, Johnson JT (1995) Tumor angiogenesis as a predictor of tumor aggressiveness and metastatic potential in squamous cell carcinoma of the head and neck. Invasion Metastasis 15(5–6):197–202PubMed
29.
Zurück zum Zitat Robbins KT, Medina JE, Wolfe GT, Levine PA, Sessions RB, Pruet CW (1991) Standardizing neck dissection terminology. Official report of the Academy’s Committee for Head and Neck Surgery and Oncology. Arch Otolaryngol Head Neck Surg 117(6):601–605CrossRefPubMed Robbins KT, Medina JE, Wolfe GT, Levine PA, Sessions RB, Pruet CW (1991) Standardizing neck dissection terminology. Official report of the Academy’s Committee for Head and Neck Surgery and Oncology. Arch Otolaryngol Head Neck Surg 117(6):601–605CrossRefPubMed
Metadaten
Titel
Postoperative radiotherapy is dispensable for OSCC patients with micrometastases in lymph nodes
verfasst von
Y. M. Pu
Y. Yang
Y. J. Wang
L. Ding
X. F. Huang
Z. Y. Wang
Y. H. Ni
Q. G. Hu
Publikationsdatum
09.04.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Virchows Archiv / Ausgabe 5/2018
Print ISSN: 0945-6317
Elektronische ISSN: 1432-2307
DOI
https://doi.org/10.1007/s00428-018-2351-z

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