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To determine the factors and the prognosis of extracapsular spread of metastatic lymph nodes in tongue squamous cell carcinoma

MAO Yuan-yuan;ZHENG Jiao-yun;DENG Sheng-yuan;WU Kun;LI Le-zhi;Hunan University of Chinese Medicine,School of Nursing;Department of Anesthesiology,Second Xiangya Hospital of Central South University;Pathology department,Second Xiangya Hospitalof Central South University;Department of Oral and Maxillofacial Surgery,the Central Hospital of Shaoyang;Department of Oral and Maxillofacial Surgery,Hunan Provincial People's Hospital;Hunan Uni-versity of Chinese Medicine,School of Nursing;Nursing Department,Second Xiangya Hospital of Central South University;  
Objective: To investigate effect of clinical and pathologic parameters on extracapsular spread( ECS) in patients with lymph nodes( LN) metastasis in tongue squamous cell carcinoma( TSCC),and determine the correlations between ECS and prognosis of TSCC patients.Methods: Subjects recruited were patients underwent a neck dissection in hospital.Sixty TSCC patients were recruited with 30 patients in ECS group and 30 patients in No-ECS group,respectively.The histologic sections of 45 dissected cervical lymph nodes with ECS from 30 patients with TSCC were examined by a single pathologist.The extent of ECS histopathologic review of involved LN was measured from the capsular margin to the farthest perindoal extension.The correlation between extent and incidence of ECS and clinical parameters,and correlations between ECS and prognosis of TSCC patients were investigated.Results: Thirty patients with 45 tumor-positive LN with ECS and 58 tumor-positive LN without ECS were analyzed.Thirty patients only had tumor-positive LN.The incidence of ECS was associated with larger LN size.The incidence of ECS was associated with lower T stage and gender.The mean and median extent values of ECS were 6. 3 and 6. 8 mm,respectively( range 0 ~ 12. 8 mm).And the ECS was ≤12 mm in 93. 3% of the 45 LN analyzed.The patients with single ECS have higher survival rate than these with multi-ECS( P0. 05).The patients with ECS6. 8 mm have a lower survival rate than these ECS6. 8 mm( P0. 05).Conclusion: The more LN numbers of ECS and ECS extension beyond 6. 8 mm were dramatically poor prognosis factors for TSCC patients.
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