Risk Factors for Cervical Lymph Node Metastasis of Head and Neck Squamous Cell Carcinoma: A Retrospective Population–Based Study

Abstract BackgroundHead and neck squamous cell carcinoma (HNSCC) is characterized by high frequency of early cervical lymph node metastases (LNM), resulting in poor survival of patients. Few researches focused on the risk factors of LNM in HSNCC patients. MethodsHNSCC patients diagnosed from 1993 to 2013 in the TCGA database formed the derivation cohort (n=316); HNSCC patients diagnosed between 2010 and 2020 at the First Affiliated Hospital of Zhejiang University, China, formed the validation cohort (n=531). Clinicopathological data (sex, age, tumor sites, tumor size, and grade) of patients from both cohorts were collected. Their associations with LNM were analyzed using univariate and multivariate logistic regression analysis.ResultsThe tumor size and grade were demonstrated to be independent risk factors for LNM of patients with HNSCC in both the derivation cohort (OR=1.669, 95% CI: 1.18~2.378, p<0.01; OR=1.85, 95% CI: 1.287~2.697, p<0.01, respectively) and the validation cohort (OR=1.338, 95% CI: 1.015~1.767, p<0.05; OR=1.936, 95% CI: 1.46~2.587, p<0.0001, respectively).ConclusionTumors with greater size and higher grade have a greater potential for lymph node metastasis, which remind us the importance of early screening and diagnosis of HNSCC.