Correlating the depth of invasion at specific anatomic locations with the risk for regional metastatic disease to lymph nodes in the neck for oral squamous cell carcinoma

Abstract

Depth of invasion and the location of the tumor are 2 important variables to consider when making treatment recommendations to patients with clinical N0 disease. © 2017 Wiley Periodicals, Inc. Head Neck 39: 974-979, 2017.

Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy

“…Brockhoff et al found different DOI cutoff values for different tumor locations determining a 20% or greater risk of having nodal metastases. They suggested to offer a neck dissection at >2 mm DOI in tongue tumors, 2‐3 mm DOI in floor of mouth tumors and 3‐4 mm DOI for the retromolar trigone and alveolus/hard palate tumors …”

Is Ultrasound a Useful Adjunct in the Management of Oral Squamous Cell Carcinoma?

“…Yesuratnam et al 6 found that USS could detect tumors no larger than 5 mm, whereas other image modalities could not. A recent study by Brockhoff et al 13 found that OSCC primary tumors as thin as 2 mm might warrant END. In this retrospective review, they found that 9% of patients with a primary tumor of 1.1 to 2 mm had at least 1 positive node.…”

Survival benefits of adjuvant radiation in the management of early tongue cancer with depth of invasion as the indication

“…[6][7][8][9][10][11][12] The risk factors studied include grade, pattern of invasion, PNI, LVSI, margins, and depth of invasion among others. A recent study by Brockhoff et al, 24 however, concludes that carcinoma of the tongue and the floor of the mouth is relatively more aggressive than other subsites and 2-mm depth of invasion should be used as an indicator for elective neck dissection, whereas in carcinoma of the retromolar trigone, alveolus, and hard palate, the significant depth of invasion is 4 mm. Close/positive margin is now an established poor prognostic factor 13,14 and recent confirmation of depth of invasion as a poor prognostic factor has raised the relevant question of adjuvant therapy in these patients.…”

“…[19][20][21][22] A meta-analysis of 16 individual series was done by Huang et al 23 who concluded that a 4-mm cutoff should be used as an indicator for elective neck dissection. A recent study by Brockhoff et al, 24 however, concludes that carcinoma of the tongue and the floor of the mouth is relatively more aggressive than other subsites and 2-mm depth of invasion should be used as an indicator for elective neck dissection, whereas in carcinoma of the retromolar trigone, alveolus, and hard palate, the significant depth of invasion is 4 mm. Some authors have also tried to propose a cutoff based only on imaging, as definitive RT can also be used as a treatment modality in selected patients.…”