Histopathologic predictors of lymph node metastasis and prognosis in tonsillar squamous cell carcinoma.
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.
['Lee|Dong Jin|DJ|', 'Kwon|Mi Jung|MJ|', 'Nam|Eun Sook|ES|', 'Kwon|Ji Hyun|JH|', 'Kim|Jin Hwan|JH|', 'Rho|Young-Soo|YS|', 'Shin|Hyung Sik|HS|', 'Cho|Seong Jin|SJ|']
Lymph nodes Prognosis Carcinoma, squamous cell Neoplasm metastasis Palatine tonsil