From Bench to Bedside in Tongue Muscle Cancer Invasion and Back again: Gross Anatomy, Microanatomy, Surgical Treatments and Basic Research

Abstract

Tongue squamous cell carcinoma is the most common malignancy in the oral cavity. Despite advances in diagnosis and treatment, the prognosis of advanced states has not significantly improved. Depth of invasion, pattern of invasion such as tumor budding grade, lingual lymph node metastasis in early stages, collective cell migration and circulating tumor cells in peripheral blood are some examples of the mechanisms that are currently receiving increasing attention in the evaluation of the prognosis of tongue cancers. Anatomic-based surgery showed that it is possible to improve loco-regional control of tongue cancer. In patients with a “T-N tract involvement”, there is significantly more distant recurrence (40%) in patients undergoing a compartmental tongue surgery. In general, the neoplastic infiltration of the lingual muscles is traced back to the finding of neoplastic tissue along the course of a muscle; however, the muscle fibers, due to their spatial conformation and the organization of the extracellular matrix, could influence the movement of tumor cells through the muscle, leaving its three-dimensional structure unchanged. We need to exclude the possibility that tongue muscle fibers represent a mechanism for the diffusion of cancer cells without muscle invasion.

Prognostic Value of Anteroposterior Extension in Oral Tongue and Floor Squamous Cell Carcinoma

“…21 Another hypothesis that could explain the worse prognosis for posterior tumors is the easier access to a wide spectrum of local pathways of spread (ie, styloglossus, genioglossus and hyoglossus, main branches of lingual and hypoglossal nerves). 22 It has been postulated that a more complex geometry of growth pattern could increase the difficulty of achieving adequate resection margins in posterior tumors. 23 Indeed, the results shown herein do not support this conclusion, as we found no relevant differences in terms of margin status between anterior and posterior tumors (eFigure 3 in Supplement 1).…”

Prognosis of tongue squamous cell carcinoma associated with individual surgical margin and pathological features

“…The optimal surgical margin of conventional OSCC has been considered to be 5 mm 9 , 10 , but this designation is controversial 11 - 14 . However, because tongue muscle invasion impact on tumor progression and has a relatively poor TSCC prognosis, and the optimal surgical margin of TSCC is still controversial and values have been proposed, including tongue compartment surgery 3 , 12 - 16 . Zanoni et al 12 suggested 0.22 cm as the optimal surgical margin for the TSCC cases, where the proportion of T 1 and T 2 stages reached 87%.…”

“…The tongue, unlike other tissues in the oral cavity, has a characteristic structure including a high content of muscle bundles and a rich lymphatic chain 2 . A high proportion of muscles in the tongue make so that it can be a routes for tumoral spread through muscle fibers, thus local recurrence could be higher with muscle invasion 3 . In addition to creating a specific tumor microenvironment, it can also induce lots of shrinkage at resection which is affected by tissue composition and tumor cells cohesiveness.(Fig.…”

Identification of ferroptosis‐related genes as potential biomarkers of tongue squamous cell carcinoma using an integrated bioinformatics approach

“…TSCC is the most common malignancy in the oral cavity; despite advances in diagnosis and treatment, the prognosis of advanced states has not significantly improved [28]. The reported 5-year rates of diseasefree survival ranged from 30% to 72% for the younger cohorts (≤45 years ) and 42% to 81% for the older cohorts [29], and the etiology of tongue cancer, especially the molecular mechanism, remains unclear.…”