A Clinical Review Of Lymphatic Metastasis Of Oral SCC And A Study Of Cancer's Impacts On Lymphangiogenesis

A Clinical Review of Lymphatic Metastasis of Oral SCC and a Study of Cancer抯 Impacts on Lymphangiogenesis Oral squamous cell carcinomas (SCC) often metastasize through lymphatic vessel and positive lymph node is an important predictive factor for worse prognosis. Survival time and life quality of patients with lymphatic metastasis is not significantly improved for years. despite progress in techniques of diagnosis and treatments. Furthermore. attentions had not been paid enough to the mechanism of lymphatic metastasis and the role of lymphatic endothelial in the procedure. This study reviewed the data of patients underwent therapy in our department for the outcomes of neck treatments. Experiments had also been carried out focused on the impacts of cancer on lymphatic endothelial proliferation, gene expression. and. lymphangiogenesis Clinical Reviews of Lymphatic Metastasis of Oral SCC 1. Necks treatments of patients ~.ith Oral SCC Three hundred and one patients were included in the follow-up study. Histopathologicall~ positive lymph nodes were found in 41 .6% of the total patients . After simply extensive resection of focus of the cancer. recurrences occurred in untreated in 32.1% of the patients. and after suprahvoid neck dissection 14.7% of the necks when cancers primarily located in tongue. buccal mucosa. lower梕ineiva. and the floor of mouth. TNM staeine is effective tbr clinical evaluation of metastasis in neck lv mph nodes. It is necessary to extend the indication ot neck dissection for above mentioned four zones. 2. Stepwise discrimination of post-operative metastasis of patients with N~ or 8 N1 necks One hundred and forty-six patients with SCC in tongue, the floor of mouth. lower r~inaiva. and huccal nmcc)sa were entered. They all had uncertained necks. Analysis of 16 clinic and therapeutic parameters showed that patterns of neck dissection and subsequent radiotherapy affected postoperative metastasis significantly (P < 0.05). Stepwise discrimination was used to set up a discrimination function for postoperative metastasis with an accuracy of 71.8% and sensitivity of 83.3%, specificity of 70.3%. 3. Impact of clinicopathologic parameters on lymphatic metastasis Ten clinicopathologic parameters were evaluated to determine their effects on lymphatic metastases of oral SCC in 193 patients. In univariate analysis, five parameters (T and N stage, pattern and depth of invasion, lymphatic infiltrating) associated significantly with histologically proved metastasis. Multivariate analysis revealed that only pattern of invasion was independent predictors of metastasis. 4. Impact of lymphatic metastasis on survival Lymphatic metastasis and other clinicopathologic parameters were evaluated to determine the effects on survival of 86 patients with tongue carcinoma. In the univariate analysis. all factors except T stage and smoking and drinking were found to have significant impact on disease-specific survival, On multivariate analysis, however. only four factors (pathologic nodal status. local recurrence. degree of differentiation, and preoperative chemotherapy were independent predictors of the survival. Impacts of cancer on Iymphangiogenesis...