Fig. 1Kaplan-Meier curves for survival with respect to T stage (T1-2 vs T3-4) (A, B), invasion to base of tongue (C, D), and skip lesions of carcinoma in situ (CIS) (E, F). Patients who have tonsillar squamous cell carcinoma with higher T stage or skip lesion of CIS have lower overall survival rates, whereas those with higher T stage, invasion to the base of the tongue, or skip lesions of CIS show decreased disease-free survival. BOT, base of tongue; CIS, carcinoma in situ.
Table 1.Clinical factors associated with ipsilateral or contralateral lymph node metastasis in patients with TSCC
Variable |
Ipsilateral LNM
|
p-value |
Contralateral LNM
|
p-value |
Absent |
Present |
Absent |
Present |
Age (yr) |
|
|
0.732 |
|
|
0.242 |
≤ 50 |
4 |
13 |
|
16 |
1 |
|
> 50 |
7 |
29 |
|
28 |
8 |
|
Gender |
|
|
1.000 |
|
|
0.574 |
Male |
10 |
38 |
|
39 |
9 |
|
Female |
1 |
4 |
|
5 |
0 |
|
Smoking (pack-yr) |
|
|
0.098 |
|
|
1.000 |
< 20 |
0 |
10 |
|
9 |
1 |
|
≥ 20 |
11 |
32 |
|
35 |
8 |
|
Alcohol (drink/wk) |
|
|
0.094 |
|
|
0.054 |
< 14 |
0 |
11 |
|
7 |
4 |
|
≥ 14 |
11 |
31 |
|
37 |
5 |
|
Tumor side |
|
|
0.256 |
|
|
1.000 |
Right |
5 |
27 |
|
26 |
6 |
|
Left |
6 |
15 |
|
18 |
3 |
|
T stage |
|
|
1.000 |
|
|
0.046*
|
T1-2 |
8 |
30 |
|
34 |
4 |
|
T3-4 |
3 |
12 |
|
10 |
5 |
|
BOT invasion |
4 |
26 |
0.177 |
22 |
8 |
0.061 |
No invasion |
7 |
16 |
|
22 |
1 |
|
Soft palate invasion |
3 |
23 |
0.175 |
18 |
8 |
0.011*
|
No invasion |
8 |
19 |
|
26 |
1 |
|
PM invasion |
2 |
7 |
0.905 |
7 |
2 |
0.646 |
No invasion |
9 |
35 |
|
37 |
7 |
|
PPW invasion |
2 |
9 |
1.000 |
7 |
4 |
0.054 |
No invasion |
9 |
33 |
|
37 |
5 |
|
NP invasion |
0 |
3 |
1.000 |
3 |
0 |
1.000 |
No invasion |
11 |
39 |
|
41 |
9 |
|
Table 2.Histopathologic factors associated with ipsilateral or contralateral lymph node metastasis in patients with TSCC
Variable |
Ipsilateral LNM
|
p-value |
Contralateral LNM
|
p-value |
Absent |
Present |
Absent |
Present |
Histologic grade |
|
|
0.482 |
|
|
1.000 |
WD or MD |
9 |
29 |
|
31 |
7 |
|
PD |
2 |
13 |
|
13 |
2 |
|
Adjacent dysplasia |
|
|
0.327 |
|
|
0.728 |
Present |
7 |
19 |
|
21 |
5 |
|
Absent |
4 |
23 |
|
23 |
4 |
|
In situ SCC |
|
|
0.488 |
|
|
0.160 |
Present |
5 |
24 |
|
22 |
7 |
|
Absent |
6 |
18 |
|
22 |
2 |
|
Skip lesion of CIS |
|
|
0.313 |
|
|
0.278 |
Present |
7 |
18 |
|
19 |
6 |
|
Absent |
4 |
24 |
|
25 |
3 |
|
Tumor necrosis |
|
|
1.000 |
|
|
0.701 |
Present |
3 |
14 |
|
15 |
2 |
|
Absent |
8 |
28 |
|
29 |
7 |
|
Invasive front |
|
|
0.183 |
|
|
0.148 |
Cohesive |
8 |
20 |
|
21 |
7 |
|
Non-cohesive |
3 |
22 |
|
23 |
2 |
|
Depth of invasion (cm) |
|
|
1.000 |
|
|
0.822 |
≤ 2 |
8 |
29 |
|
31 |
6 |
|
> 2 |
3 |
13 |
|
13 |
3 |
|
Lymphatic invasion |
|
|
< 0.001*
|
|
|
0.092 |
Present |
3 |
37 |
|
31 |
9 |
|
Absent |
8 |
5 |
|
13 |
0 |
|
Muscle invasion |
|
|
0.002*
|
|
|
0.701 |
Present |
3 |
33 |
|
29 |
7 |
|
Absent |
8 |
9 |
|
15 |
2 |
|
Perineural invasion |
|
|
0.322 |
|
|
1.000 |
Present |
0 |
7 |
|
6 |
1 |
|
Absent |
11 |
35 |
|
38 |
8 |
|
Ipsilateral ECS |
|
|
< 0.001*
|
|
|
0.010*
|
Present |
0 |
33 |
|
24 |
9 |
|
Absent |
11 |
9 |
|
20 |
0 |
|
Table 3.Univariate analyses of potential prognostic variables for survival
|
Disease-free survival (p-value) |
Overall survival (p-value) |
Age (≤ 50 yr vs > 50 yr) |
0.137 |
0.064 |
Sex (female vs male) |
0.289 |
0.277 |
Smoking (< 20 pack-yr vs ≥ 20 pack-yr) |
0.055 |
0.071 |
Alcohol (< 14 drink/wk vs ≥ 14 drink/wk) |
0.808 |
0.440 |
T stage (T1,2 vs T3,4) |
0.046*
|
0.012*
|
N stage (N0 vs N1,2,3) |
0.304 |
0.447 |
Stage (I-II vs III-IV) |
0.539 |
0.658 |
BOT invasion (no vs yes) |
0.033*
|
0.063 |
Soft palate invasion (no vs yes) |
0.131 |
0.241 |
Pterygoid muscle invasion (no vs yes) |
0.083 |
0.094 |
PPW invasion (no vs yes) |
0.186 |
0.082 |
Histologic grade (WD, MD vs PD) |
0.070 |
0.067 |
Adjacent dysplasia (no vs yes) |
0.059 |
0.097 |
In situ SCC (no vs yes) |
0.480 |
0.330 |
Skip lesion of CIS (no vs yes) |
0.039*
|
0.049*
|
Tumor necrosis (no vs yes) |
0.361 |
0.200 |
Invasive front (cohesive vs noncohesive) |
0.115 |
0.286 |
Depth of invasion (≤ 2 cm vs > 2 cm) |
0.159 |
0.107 |
Lymphatic invasion (no vs yes) |
0.210 |
0.319 |
Perineural invasion (no vs yes) |
0.140 |
0.521 |
Superior constrictor muscle invasion (no vs yes) |
0.108 |
0.172 |
Table 4.Multivariate analyses of disease-free and overall survival rates in TSCC patients
|
Disease-free survival
|
p-value |
Overall survival
|
p-value |
|
HR |
95% CI |
HR |
95% CI |
BOT invasion |
1.968 |
0.727-5.328 |
0.183 |
- |
- |
- |
Skip lesion of CIS |
2.189 |
1.975-4.914 |
0.048*
|
2.230 |
0.979-5.081 |
0.056 |
T1,2 vs T3,4 |
1.567 |
0.628-3.913 |
0.336 |
3.060 |
1.071-8.746 |
0.019*
|