The prediction of lymph node metastases from oral squamous carcinoma

M. Shear, D. M. Hawkins, H. W. Farr

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68 Scopus citations


In an attempt to predict which cases of oral and oropharyngeal squamous carcinoma are likely to metastasize to regional lymph nodes a series of 898 cases was grouped according to site, size, grade of histological differentiation, and presence or absence of histologically confirmed regional lymph node metastases. The results were analysed by a logistic multiple regression analysis. They showed that the sites may be divided into three clusters. Cluster 1 consists of tumors of lip, floor of mouth, cheek mucosa, hard palate, and gingiva. These are not significantly different as regards metastasis rate. Cluster 2 consists of tumors of the anterior two‐thirds of tongue and has a higher tendency to metastasis than those in Cluster 1. Lesions of the posterior third of tongue and oropharynx form Cluster 3 which exhibits the greatest tendency to metastasis. Sizes of primary lesions are clustered in groups of lesions less than 3 cm, those 3 to less than 4 cm, and those 4 cm or larger, in ascending tendency to metastasis. Well‐differentiated and moderately differentiated tumors are not significantly different in their tendency to metastasize and may be reduced to a single cluster, whereas poorly differentiated tumors have a markedly higher metastasis rate. Using these clusters it has been possible to predict the logistically transformed probability of metastasis to a high degree of accuracy (R = 0.9398). From this we conclude that if for a given tumor we know to which site, size or differentiation cluster it belongs, we can then estimate its probability of metastasising.

Original languageEnglish (US)
Pages (from-to)1901-1907
Number of pages7
Issue number4
StatePublished - Apr 1976
Externally publishedYes


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