Predictors of Occult Neck Metastasis and Extra Capsular Spread in Early Oral Cancers

Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2122-2128. doi: 10.1007/s12070-020-02020-7. Epub 2020 Aug 7.

Abstract

To investigate the incidence of occult neck metastasis and to determine the prognostic factors related to the occurrence of the cervical lymph nodal metastasis and extra capsular extension (ECE) in early oral cavity cancer patients. A retrospective review performed on 100 patients with node negative squamous cell carcinoma of oral cavity who underwent primary treatment between Jan 2015 and Dec 2018. Incidence of occult neck metastasis after the elective neck dissection in our study was 35%. Independent correlates of positive occult neck metastasis were lymphovascular Invasion (P-0.000)[CI 0.004-0.326] and depth of invasion(P-0.009)[CI 0.509-13.428] on univariate analysis and statistically significant factors associated with the incidence of the extracapsular extension were age(P-0.044), lymphovascular invasion(P-0.018)[CI 0.004-0.603] and lymph node ratio(P-0.000)[CI 4.570-158.45] on univariate analysis. Lymphovascular invasion and depth of invasion correlated significantly with occurrence of neck metastasis. Age and LVI were the prognostic factors for extra capsular spread.

Keywords: Early oral cancers; Extra capsular spread; Lymphnodal metastasis; Occult neck metastasis.