• Shin-Ichi Yamada, Mitsunobu Otsuru, Souichi Yanamoto, Takumi Hasegawa, Hitoshi Aizawa, Takahiro Kamata, Nobuhiro Yamakawa, Tomoyuki Kohgo, Akira Ito, Yuri Noda, Chihoko Hirai, Tetsuya Kitamura, Masaya Okura, Tadaaki Kirita, Michihiro Ueda, Tetsuro Yamashita, Yoshihide Ota, Takahide Komori, Masahiro Umeda, and Hiroshi Kurita.
• Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan. yshinshin@shinshu-u.ac.jp.
• Clin Oral Investig. 2018 Apr 1; 22 (3): 1311-1318.

ObjectivesThe progression level of extracapsular spread (ECS) for cervical lymph node metastasis of oral squamous cell carcinoma (OSCC) was previously divided into three types, and their relationships with the prognosis of patients were re-examined.Patients And MethodsThe Kaplan-Meier method was used to examine overall survival (OS) and relapse-free survival (RFS) curves. Prognosis factor for recurrence was analyzed with univariate and multivariate analysis.ResultsECS was detected in 216 cases of OSCC and analyzed. The 5-year overall survival and RFS rates of patients with type C, which was microscopically defined as tumor invasion to perinodal fat or muscle tissue, were significantly poor at 40.6 and 37.8%, respectively. The results of a univariate analysis suggested that the prognosis of ECS in OSCC patients is associated with its progression level, particularly type C. The 5-year RFS rate of type C with tumor budding was significantly poor at 31.5%. Type C with tumor budding correlated with local and regional recurrence as well as distant metastasis. In a multivariate analysis, tumor budding was identified as an independent prognostic factor.ConclusionsThese results suggest that the progression level of ECS and tumor budding are useful prognostic factors in OSCC patients.Clinical RelevanceThis study indicated that the progression level and tumor budding of ECS for cervical lymph node metastasis were useful prognostic factors in OSCC patients.

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