The number of metastatic nodes is an important predictor of oral cavity cancer mortality, and carries more value than lymph node size and contralaterality, according to a study involving >14,500 individuals. Participants had oral cavity squamous cell carcinoma and were undergoing upfront surgical resection for curative intent. Investigators looked at the link between number of metastatic lymph nodes and survival. Among the results:
- ~7,900 patients were node-negative, and ~6,650 were node-positive.
- Mortality risk escalated with increasing number of metastatic nodes, without plateauing.
- Patients with up to 4 lymph nodes had a 34% higher risk of experiencing oral cavity cancer mortality.
- Those with extranodal extension had a 41% higher risk of such.
- Patients with lower neck involvement had a 16% higher risk.
- Increasing number of nodes examined was linked with improved survival.
- Contralateral lymph node involvement and lymph node size were not linked with mortality.
Ho A, Kim S, Tighiouart M, et al. Metastatic lymph node burden and survival in oral cavity cancer. [Published online ahead of print September 7, 2017]. J Clin Oncol. doi:10.1200/JCO.2016.71.1176.