Korean J Pathol.  2013 Jun;47(3):203-210.

Histopathologic Predictors of Lymph Node Metastasis and Prognosis in Tonsillar Squamous Cell Carcinoma

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 2Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
  • 3Department of Pathology, Ilsong Memorial Institute of Head and Neck Cancer, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. apilas@hanmail.net
  • 4Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Institute of Head and Neck Cancer, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Risk factors for lymph node metastasis in tonsillar squamous cell carcinoma (TSCC) need to be established to determine the degree of surgery required to achieve high curative rates. However, little is known currently about the histopathological features predicting prognosis, specifically in TSCC.
METHODS
This study included 53 patients who underwent surgical resection with neck dissection. Clinicopathological factors investigated included age, gender, alcohol use, tobacco consumption, tumor stage, adjacent structure involvement, cell differentiation, squamous dysplasia, in situ carcinoma associated with primary invasive cancer, carcinoma in situ skip lesions, necrosis, invasive front, depth of invasion, and lymphatic, muscle, or perineural invasion.
RESULTS
Contralateral cervical metastasis was associated with higher T stages and soft palate invasion. Lymphatic and muscle invasion were associated with ipsilateral cervical metastasis. Advanced T stage, invasion to the base of tongue, and skip lesions were associated with decreased disease-free survival. Advanced T stage and skip lesions were associated with worse overall survival.
CONCLUSIONS
Advanced T stage and soft palate invasion may predict a high risk of contralateral nodal metastasis. T stage and skip lesion are worse prognostic factors in TSCC and should be commented in pathology reports.

Keyword

Palatine tonsil; Carcinoma, squamous cell; Prognosis; Lymph nodes; Neoplasm metastasis

MeSH Terms

Carcinoma in Situ
Carcinoma, Squamous Cell
Cell Differentiation
Disease-Free Survival
Humans
Lymph Nodes
Muscles
Neck Dissection
Necrosis
Neoplasm Metastasis
Palate, Soft
Palatine Tonsil
Prognosis
Risk Factors
Tobacco
Tongue
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