For early-stage oral tongue cancer, depth of invasion and worst pattern of invasion are the strongest pathological predictors for locoregional recurrence and mortality

Almangush, Alhadi; Bello, Ibrahim O.; Coletta, Ricardo D.; Mäkitie, Antti; Mäkinen, Laura K.; Kauppila, Joonas H.; Pukkila, Matti; Hagström, Jaana; Laranne, Jussi; Soini, Ylermi; Kosma, Veli Matti; Koivunen, Petri; Kelner, Natalie; Kowalski, Luiz Paulo; Grénman, Reidar; Leivo, Ilmo; Läärä, Esa; Salo, Tuula

doi:10.1007/s00428-015-1758-z

Cited by 118 publications

(140 citation statements)

References 41 publications

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“…When the tumor depth was between 4-9mm, there was 44% subclinical nodal metastasis, 7% local recurrence and 76% 5 year survival was detected; and they suggested elective neck dissection. Likewise, in another study, high recurrence and metastasis risk was found to be present in tumors with an invasion depth of 4 mm or more 14. In our study, it was found to be statistically significant that ipsilateral metastasis risk increases when tumor depth increased.…”

Section: Discussionsupporting

confidence: 77%

Prognostic factors of recurrence and neck metastasis in oral carcinomas

Sahin¹,

Bulğurcu²,

Arslan³

et al. 2016

Pak J Med Sci

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Objective:To assess the effects of tumor size, proximity to midline and invasion depth of oral cancer of the tongue (TC) on neck metastasis and recurrence.Methods:In this retrospective observational study, was conducted through a chart review of the 11 male and 9 female patients who underwent surgeries with the diagnosis of tongue squamous cell carcinoma and at least one side neck dissection. We wanted to assess effects of tumor size, proximity to midline, and invasion depth of TC, according to the surgical specimens and pre-operative magnetic resonance imaging, on neck metastasis and recurrence between 2007 and 2014. The study was conducted in a training hospital-based otorhinolaryngology clinic. Statistical analyses were performed to determine possible relationship between such tumor features and tumor recurrence and neck metastasis.Results:Statistically significant relationship were detected between recurrence and the proximity of tumor to midline (p=0.031) and between invasion depth and neck metastasis (p=0.017). No relationship was found between tumor size and recurrence and neck metastasis (p=0.721 and p=0.827, respectively).Conclusions:Parameters like invasion depth and tumor proximity to midline might provide useful information about prognosis and may help to determine a treatment schedule in patients suffering fdrom cancer of the tongue. The present TNM classification might not be sufficient to provide enough information to determine prognosis and staging adequately in these patients.

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Section: Discussionsupporting

confidence: 77%

Prognostic factors of recurrence and neck metastasis in oral carcinomas

Sahin¹,

Bulğurcu²,

Arslan³

et al. 2016

Pak J Med Sci

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“…DOI assesses the invasiveness of a carcinoma regardless of its exophytic component . Its use as a prognostic factor and criterion for neck dissection (ND) in patients with OCSCC has been the topic of multiple clinical analyses, and DOI > 4 mm has been shown to be associated with worse outcomes . However, these studies have been heterogeneous and frequently included patients of any stage and with multiple risk factors for recurrence.…”

Section: Introductionmentioning

confidence: 99%

Depth of invasion alone as a prognostic factor in low‐risk early‐stage oral cavity carcinoma

Kozak¹,

Shah²,

Chen

et al. 2019

The Laryngoscope

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Objectives To evaluate the significance of increasing depth of invasion (DOI) as the sole risk factor for recurrence in patients with low‐risk early‐stage oral cavity squamous cell carcinoma (OCSCC). Methods We retrospectively reviewed 560 patients with OCSCC treated at our institution between 2003 and 2013. Patients were included if they had low‐risk early‐stage OCSCC treated with surgical resection ± neck dissection and no adjuvant therapy. Low risk was defined as absence of positive or close margins, lymphovascular invasion, perineural invasion, and positive lymph nodes. Patients with tumor (T)3‐T4 disease were excluded. Pathology specimens were independently re‐reviewed by two board‐certified pathologists to confirm proper measurement of DOI. Kaplan‐Meier and Cox proportional hazards regression analyses were performed to identify factors predictive for recurrence as well as progression‐free survival (PFS) and overall survival (OS). Results A total of 126 patients with low‐risk early‐stage T1‐2N0 OCSCC were included. Median follow‐up time was 42.5 months and median DOI was 4 mm. There was no significant difference in incidence of local (P = 0.95), regional (P = 0.81), or distant recurrence (P = 0.96) among patients with DOI < 4 mm versus ≥4 mm. On multivariable analysis, DOI was significant for both PFS (P = 0.03) and OS (P = 0.002). Conclusion In this study, we show that in the absence of other high‐risk pathologic features, DOI ≥ 4 mm does not portend for increased incidence of local, regional, or distant relapse in patients treated with surgery alone; however, increasing DOI is a marker for worse PFS and OS in patients with low‐risk, early‐stage OCSCC. Level of Evidence 4 Laryngoscope, 129:2082–2086, 2019

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“…Tongue squamous cell carcinoma (SCC) is the most common malignancy of the oral cavity [2], and nodal metastasis has been reported as one of the prognostic factors for patients with tongue SCC [3].…”

Section: Introductionmentioning

confidence: 99%

The role of prophylactic neck dissection and tumor thickness evaluation for patients with cN0 tongue squamous cell carcinoma

Tsushima

Sakashita

Homma

et al. 2016

Eur Arch Otorhinolaryngol

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Purpose. Prophylactic neck dissection (PND) for patients with clinically N0 (cN0) tongue carcinoma remains controversial. We assessed the efficacy of PND for patients with cN0 tongue squamous cell carcinoma (SCC) and investigated the prognostic role of tumor thickness as assessed by diagnostic imaging in predicting the risk of nodal micrometastasis or late nodal recurrence. Methods. Eighty-eight patients with cN0 tongue carcinomas underwent surgical treatment. Tumor thickness was measured from magnetic resonance (MR) images or computed tomography (CT) scans. Results. The overall survival rates of patients with or without PND were 94% and 81%, respectively (p=0.2857). MR images or CT scans were available for 68 patients. A tumor thickness ≧10mm or ≧5mm did not increase the probability of nodal metastasis, with late nodal metastasis observed in 15% of patients with graphically undetected small tumors. Conclusions. PND appears to have the potential to improve overall survival for patients with cN0 tongue SCC. Careful follow-up management or PND is considered to be needed regardless of tumor thickness in the pre-treatment evaluation

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For early-stage oral tongue cancer, depth of invasion and worst pattern of invasion are the strongest pathological predictors for locoregional recurrence and mortality

Cited by 118 publications

References 41 publications

Prognostic factors of recurrence and neck metastasis in oral carcinomas

Prognostic factors of recurrence and neck metastasis in oral carcinomas

Depth of invasion alone as a prognostic factor in low‐risk early‐stage oral cavity carcinoma

The role of prophylactic neck dissection and tumor thickness evaluation for patients with cN0 tongue squamous cell carcinoma

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