Survival Impact of Lingual Lymph Node Metastases in Tongue Cancer: An Analysis Regarding Anatomical Subsites

Abstract

Background/Aim: Lingual lymph node (LLN) metastasis from tongue cancer occurs at four subsites. However, subsite-related prognosis is unknown. This study aimed to analyze the association between LLN metastases and disease-specific survival (DSS) with respect to these four anatomic subsites. Patients and Methods: Patients with tongue cancer treated between January 2010 and April 2018 at our institute were reviewed. The four subgroups of LLNs were median, anterior lateral, posterior lateral, and parahyoid. DSS was evaluated. Results: LLN metastases occurred in 16 of the 128 cases; six and 10 cases were identified during initial and salvage therapy, respectively. Zero, four, three, and nine cases were median, anterior lateral, posterior lateral, and parahyoid LLN metastases, respectively. The 5-year DSS of patients with LLN metastasis was significantly poor on univariate analysis; parahyoid LLN metastasis showed the worst prognosis. Multivariate analysis indicated that only advanced nodal stage and lymphovascular invasion were significant survival factors. Conclusion: Parahyoid LLNs may require the most caution in tongue cancer. The significance of LLN metastases alone for survival was not confirmed on multivariate analysis.