Influencing factors of cervical lymph node metastasis after radical surgery for oral squamous cell carcinoma in stages T1 and T2 and construction of a prediction model

doi:10.19438/j.cjoms.2025.05.007

Abstract

Abstract: PURPOSE: To investigate the influencing factors for cervical lymph node metastasis in stage T1 and T2 oral squamous cell carcinoma(OSCC) after radical surgery and to construct nomogram prediction models. METHODS: This retrospective cohort study collected clinical data from 134 patients diagnosed with stage T1-T2 OSCC at Xuzhou Central Hospital. The data included patients' general information, cervical lymph node metastasis, tissue differentiation degree, tumor budding, depth of invasion, lymphovascular invasion, peripheral nerve invasion, squamous cell carcinoma antigen (SCC-Ag) levels, et al. Logistic regression analysis was employed to identify independent factors influencing cervical lymph node metastasis, leading to the construction of a nomogram to visualize the prediction model. The study also involved drawing receiver operating characteristic curves, calibration curves, and clinical decision curves to evaluate the discrimination, calibration, and clinical validity of the prediction model. RESULTS: T stage, degree of tissue differentiation, depth of invasion and lymphovascular invasion were independent factors influencing cervical lymph node metastasis in early OSCC. The area under the curve(AUC) for the nomogram prediction model was 0.875, with a sensitivity of 87.80% and a specificity of 72.04%, demonstrating good discrimination and calibration. The clinical decision curve analysis revealed that this nomogram offered a significant net benefit in predicting the risk of cervical lymph node metastasis in early-stage OSCC, affirming its clinical validity. CONCLUSIONS: T stage, degree of tissue differentiation, depth of invasion, and lymphovascular invasion were independent risk factors for cervical lymph node metastasis in patients with T1-T2 stage oral squamous cell carcinoma. The established nomogram prediction model demonstrated strong detection performance and could be effectively utilized for patients with clinically early-stage OSCC. These precise treatment plans offered valuable reference points.

Key words: Oral squamous cell carcinoma, Head and neck cancer, Cervical lymph node metastasis, Depth of infiltration, Lymphatic vascular invasion, Nomogram, Predictive model

CLC Number:

R739.8

Zhang Wangru, Chen Yuanyuan, Li Zhiping, Meng Jian, Peng Sen. Influencing factors of cervical lymph node metastasis after radical surgery for oral squamous cell carcinoma in stages T1 and T2 and construction of a prediction model[J]. China Journal of Oral and Maxillofacial Surgery, 2025, 23(5): 469-475.

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