Outcome Analysis of Patients with pN2 Oral Cavity Cancer

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Abstract
The American Joint Committee on Cancer staging system suggests that squamous-cell carcinoma of the oral cavity (OSCC) with pN2 should be classified as stage IVA. The objective of the current study was to determine the outcome of patients with pN2 OSCC cancer according to different T status. Between January 1996 and September 2007, a total of 270 patients with pN2 OSCC cancer were analyzed. All participants had a follow-up of at least 2 years or were censored on the date of last follow-up. The outcome measures for this study were the 5-year rates of locoregional control, distant metastases, and survival. Five-year disease-specific survival and overall survival rates in pT1 (n = 9), pT2 (n = 98), pT3 (n = 70), and pT4 (n = 93) patients were 78%, 66%, 49%, 35% (P = 0.0031), and 78%, 52%, 35%, 23% (P = 0.0001), respectively. Multivariable analysis revealed that pT3-4, level IV/V metastases, extracapsular spread, and poor differentiation were independent risk factors for 5-year disease-specific survival in the entire study cohort. Specific independent prognostic factors for 5-year disease-specific survival according to T stage were found. The results of this study suggest that patients with pN2 OSCC cancer have different outcomes and prognostic factors according to their T status. In the light of these findings, treatment strategies may be quite different.

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