Nodal factors predictive of recurrence and survival in patients with oral cavity squamous cell carcinoma

Clin Otolaryngol. 2018 Apr;43(2):470-476. doi: 10.1111/coa.12995. Epub 2017 Oct 17.


Objectives: Lymph node (LN) metastasis of oral cavity squamous cell carcinoma (OSCC) is associated with survival outcomes. However, the relationship between different metastatic nodal factors and treatment outcomes requires further elucidation. This study examined nodal factors predictive of recurrence and survival in patients with OSCC.

Methods: This prospective observational study included 157 patients with OSCC who underwent surgery between 2010 and 2015. Clinicopathological and follow-up information were recorded. Univariate and multivariate Cox proportional hazard models were performed to identify factors associated with recurrence-free survival, disease-specific survival and overall survival.

Results: Sixty-five of 157 patients (41.4%) had neck metastasis. During a median follow-up of 46 months, any recurrences and all deaths occurred in 43 (27.4%) and 43 (27.4%) of cases, respectively. All nodal factors (LN classification, size, number and ratio) and extra-nodal extension were significantly associated with all survival outcomes (P < .001). Multivariate analyses indicated that a tumour size >2 cm and LN ratio were independently associated with all survival (P < .05). Patients with LN ratio >0.05 had sixfold higher recurrence and mortality rates than other patients (P < .001).

Conclusion: Lymph node ratio is an independent and predictive determinant of post-treatment recurrence and survival.

Keywords: lymphatic metastasis; oral cavity; recurrence; squamous cell carcinoma; survival.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouth Neoplasms / mortality*
  • Mouth Neoplasms / pathology*
  • Mouth Neoplasms / therapy
  • Neoplasm Recurrence, Local / epidemiology*
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Prospective Studies
  • Survival Rate
  • Young Adult