A model to predict nodal metastasis in patients with oral squamous cell carcinoma

被引:41
作者
De Silva, R. K. [1 ]
Siriwardena, B. S. M. S. [2 ]
Samaranayaka, A. [3 ]
Abeyasinghe, W. A. M. U. L. [2 ]
Tilakaratne, W. M. [2 ]
机构
[1] Univ Otago, Dept Oral Diagnost & Surg Sci, Fac Dent, Dunedin, New Zealand
[2] Univ Peradeniya, Fac Dent Sci, Dept Oral Pathol, Peradeniya, Sri Lanka
[3] Univ Otago, Dept Prevent & Social Med, Fac Med, Dunedin, New Zealand
关键词
UPPER AERODIGESTIVE TRACT; TUMOR THICKNESS; TONGUE CANCER; HISTOPATHOLOGIC PARAMETERS; CERVICAL METASTASIS; PROGNOSTIC-FACTORS; NECK DISSECTION; NEGATIVE NECK; LOWER LIP; STAGE-I;
D O I
10.1371/journal.pone.0201755
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Difficulty in precise decision making on necessity of surgery is a major problem when managing oral squamous cell carcinomas (OSCCs) with clinically negative neck. Therefore, use of clinical and histopathological parameters in combination would be important to improve patient management. The main objective is to develop a model that predicts the presence of nodal metastasis in patients with OSCC.623 patients faced neck dissections with buccal mucosal or tongue squamous cell carcinoma (SCC) were selected from patients' records. Demographic data, clinical information, nodal status, Depth of invasion (DOI) and pattern of invasion (POI) were recorded. The parameters which showed a significant association with nodal metastasis were used to develop a multivariable predictive model (PM). Univariate logistic regression was used to estimate the strengths of those associations in terms of odds ratios (OR). This showed statistically significant associations between status of the nodal metastasis and each of the following 4 histopathological parameters individually: size of the tumour (T), site, POI, and DOI. Specifically, OR of nodal metastasis for tongue cancers relative to buccal mucosal cancers was 1.89, P-value <0.001. Similarly, ORs for POI type 3 and 4 relative to type 2 were 1.99 and 5.83 respectively. A similar relationship was found with tumour size; ORs for T2, T3, and T4 compared to T1 were 2.79, 8.27 and 8.75 respectively. These four histopathological parameters were then used to develop a predictive model for nodal metastasis. This model showed that probability of nodal metastasis is higher among tongue cancers with increasing POI, with increasing T, and with larger depths while other characteristics remained unchanged. The proposed model provides a way of using combinations of histopathological parameters to identify patients with higher risks of nodal metastasis for surgical management.
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页数:16
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