Lymphnode metastasis in head and neck squamous cells carcinoma: Multivariate analysis of prognostic variables

Cervical lymphnodes metastatization by the squamous cell carcinoma of the h ead and neck is well known as a prognostic negative factor as far as surviv al is concerned. Multivariate analysis has been used on 207 cases of head a nd neck squamous cell carcinomas (HNSCC) in order to identify the possible prognostic significance of a group of clinical and histopathological charac teristics, aiming to find a correlation with the possible occurrence of cer vical lymphnodes. Two hundred and seven patients (168 males and 39 females, mean age: 62 year s) with SCCHN were studied. They underwent surgery alone and radiotherapeut ic associated treatment. Variables regarding the patient, carcinoma and his tology were analysed: age, sex, smoking and alcohol consumption, performanc e status, concomitant internal pathologies (cardiopathies, hepatopathies, b roncho-pneumopathies, metabolic disorders), site and size of primary tumor (T stage), number and size of laterocervical lymph node localization (clini cal N stage), grading, vascular permeation, perineural infiltration. Multiv ariate analysis of prognostic factors was performed using BMDP's PLR progra mme. Some variables showed a great risk of lymphnode metastasis; among sites: su praglottic larynx (p=0.05), base of the tongue (p=0.04), hypopharynx (p=0.0 5); some histological parameters as lower degree of histological differenti ation (p=0.02), the presence of vascular permeation (p=0.06) and perineural invasion (p=0.07) appear to represent predisponing factors for the onset o f adenopathies. By considering prognostic factors as shown, it is possible to better identi fy metastasis risk cases, that leads to improved therapeutical strategies.