A Study on Tumor Budding Guiding Individualized Surgical Planning of Early-stage Oral Squamous Cell Carcinoma.

Oral squamous cell carcinoma is the most common malignant tumor of oral and maxillofacial region, and prone to early cervical lymph node metastases. Lymphatic spread is associated with increased risk of loco-regional recurrence, therefore, the identification of lymph node metastases preoperatively is very important for the optimal surgical therapy. Recently, cervical lymph node dissection(CLND) is performed in the presence of oral squamous cell carcinoma. However, whether cervical lymph node dissection is necessarily performed in the presence of early-stage oral squamous cell carcinoma is still controversial. CLND will represent over-treatment in some case of early-stage oral squamous cell carcinoma. Therefore, How to accurately predict whether a patient should be performed CLND is important. Our previous study show that tumor budding is closely related to lymphatic spread in the oral squamous cell carcinoma. The purpose of this study is to find that whether the tumor budding guide the individualized surgical planning of early-stage oral squamous cell carcinoma.

Inclusion criteria

• Han race;
• Oral squamous cell carcinoma is confirmed by pathology;
• The section of oral squamous cell carcinoma including primary two-thirds prior to the tongue, buccal mucosa， gingiva， mouth floor， hard palate mucosa;
• The primary lesion is no more than 4cm;
• Do not find cervical lymph node metastases and distant metastasis in the clinical examination including physical examination and MRI;
• Patients and families agree to participate in the study;
• Patients do not have cognitive disorders.

Exclusion criteria

• Do not meet the inclusion criteria;
• The primary lesion is more than 4cm or invade adjacent tissues;
• Do not review on schedule;
• Patients receive not only surgical procedures, but other antineoplastic treatment;
• There are serious adverse events after operation;
• Patients quit the study voluntarily;
• Patients quit the study because of physical condition.