Erken evre oral kavite kanserlerinde boyun metastazının ön belirteçleri

Yıl 2015, Cilt: 5 Sayı: 2, 82 - 86, 14.01.2016

Süha Ertuğrul , Gökşen Ertuğrul Abdülkadir İmre Ercan Pınar Çağlar Çallı Aylin Orgen Çallı Semih Öncel

Öz

Amaç: Erken evre oral kavite kanserlerinde klinik ve histopatolojik parametrelerin boyun metastazına olan etkilerini saptamak.

Yöntem: Erken evre oral kavite karsinomu nedeniyle İzmir Atatürk Eğitim ve Araştırma Hastanesinde Haziran 2001 ile Haziran 2010 tarihleri arasında primer cerrahi rezeksiyon ve eş zamanlı boyun diseksiyonu yapılan 92 hastanın medikal kayıtları retrospektif olarak incelendi. Klinik ve histopatolojik parametrelerin boyun metastazı ile olan ilişkileri değerlendirildi. Histolojik verilerden, tümör genişliği ve tümör derinliğinin ölçümü operatif dokunun histolojik kesitleri ile elde edildi. Optik mikrometre ile horizontal planda maksimum genişlik ve vertikal planda maksimum derinlik ölçüldü ve maksimum derinlik tümör kalınlığı olarak kayıt edildi.

Bulgular: Oral kavite kanserlerinde, tümör lokalizasyonu, T evresi, diferansiyasyon derecesi, tümör kalınlığı, perinöral invazyon, vasküler invazyon ve perilenfatik invazyon ile boyun metastazı arasındaki ilişki istatiksel olarak anlamlı bulundu (p<0.05). Boyun metastazı için kritik tümör kalınlığı değeri 5.6 mm olarak bulundu.

Sonuç: Bu çalışmanın sonuçlarına göre, oral kavite kanserlerinde boyun metastazı gelişiminde 5.6 mm tümör kalınlığı kritik değerdir. Bu değeri aşan hastalarda boyun metastazı riski belirgin olarak artmaktadır. Gizli metastaz riski yüksek olan oral kavite kanserlerinde tümör kalınlığı preoperatif ya da peroperatif olarak saptanabilir ve kritik değerleri aştığında elektif boyun diseksiyonuna karar verilebilir.

Anahtar sözcükler: Boyun metastazı, oral kavite kanseri, tümör kalınlığı.

Anahtar Kelimeler

Boyun metastazı, oral kavite kanseri, tümör kalınlığı

Predictors of neck metastasis in early stage oral cavity cancer

Öz

Objective: To identify the effects of clinical and histopathological
parameters on neck metastasis in early-stage oral cavity cancers.
Methods: The medical records of 92 patients who underwent primary
surgical resection and concurrent neck dissection due to early-stage oral
cavity squamous cell cancer at ‹zmir Atatürk Training and Research
Hospital between June 2001 and June 2010 were retrospectively
reviewed. The associations of clinical and histological parameters with
neck metastasis were assessed. Based on the histological data, the histological sections of the operative tissue were obtained via the measurement of tumor width and tumor depth. Using an optical micrometer,
the maximum width at the horizontal plane and the maximum depth at
the vertical plane were measured and the maximum depth was recorded as tumor thickness.
Results: The association between neck metastasis and tumor localization,
T stage, degree of differentiation, tumor thickness, perineural invasion,
vascular invasion and perilymphatic invasion in early-stage oral cavity cancers was found statistically significant (p<0.05). The value of critical tumor
thickness for the neck metastasis was found to be 5.6 mm.
Conclusion: On the basis of our results, a tumor thickness of 5.6 mm is
the critical value for the development of neck metastasis in oral cavity
cancers. The neck metastasis risk showed a significant increase in cases
where the tumor thickness exceeded this threshold value. In oral cavity cancers with a high risk of occult metastasis, the tumor thickness may
be identified pre-operatively or intra-operatively and, a decision can be
taken to perform neck dissection when they exceed critical values. 

Anahtar Kelimeler

Neck metastasis, oral cavity cancer, tumor thickness

Kaynakça

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• Please cite this article as: Ertuğrul S, Ertuğrul G, İmre A, Pınar E, Çallı Ç, Orgen Çallı A, Öncel S. Predictors of neck metastasis in early stage oral
• cavity cancer. ENT Updates 2015;5(2):82–86.