Retrospective observational study of occult cervical lymph-node metastasis in T1N0 tongue cancer

Imai, Takayuki; Satoh, Ikuro; Matsumoto, Kazuya; Asada, Yukinori; Yamazaki, Tomoko; Morita, Shinkichi; Saijo, Satoshi; Okubo, Junichi; Wakamori, Shun; Saijo, Shigeru; Matsuura, Kazuto

doi:10.1093/jjco/hyw172

Cited by 32 publications

(15 citation statements)

References 21 publications

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“…A large number of authors have reported that early stage node-negative OSCC developing regional metastasis has a poor prognosis [ 3 , 13 , 25 ]. There are two options for treatment of the neck in clinically node-negative OSCC.…”

Section: Discussionmentioning

confidence: 99%

Tumor budding is an independent prognostic marker in early stage oral squamous cell carcinoma: With special reference to the mode of invasion and worst pattern of invasion

et al. 2018

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Pathologically proven regional lymph node metastasis affects the prognosis in early stage oral cancer. Therefore we investigated invasive tumor patterns predicting nodal involvement and survival in patients with clinically node-negative T1 and T2 oral squamous cell carcinoma (cT1,2N0M0 OSCC). Ninety-one cases of cT1,2N0M0 OSCC treated with transoral resection of the primary tumor were assessed based on 3 types of invasive tumor patterns on histopathologic and pancytokeratin-stained immunohistological sections: the mode of invasion, worst pattern of invasion (WPOI), and tumor budding. The correlations among invasive tumor patterns, regional metastasis, and disease-free survival were analyzed. Of the 91 cases, 22 (24%) had pathologically proven regional metastasis. The mode of invasion (p<0.01) and tumor budding (p<0.01) were associated with regional metastasis as well as lymphovascular invasion (p = 0.04) in univariate analysis. In logistic regression analysis, however, tumor budding was the only independent predictor of regional metastasis (hazard ratio (HR) = 3.05, 95% confidence interval (CI) = 0.29–5.30, p<0.01). All three invasive patterns, the mode of invasion, WPOI, and tumor budding, were found to be significant predictors of 5-year disease-free survival (p<0.01, p = 0.03, and p<0.01, respectively) as well as lymphovascular invasion (p = 0.02) and perineural invasion (p = 0.02). A final model for Cox multivariate analysis identified the prognostic advantage of the intensity of tumor budding (HR = 2.19, 95% CI = 1.51–3.18, p<0.01) compared with the mode of invasion and WPOI in disease-free survival. Our results indicate that the intensity of tumor budding may be a novel diagnostic biomarker, as well as a therapeutic tool, for regional metastasis in patients with cT1,2N0M0 OSCC. If the pancytokeratin-based immunohistochemical features of more than five buds, and a grade 4C or 4D mode of invasion are identified, careful wait-and-see follow-up in a short period with the use of imaging modalities is desirable. If there are more than ten buds, a grade 4D mode of invasion, or WPOI-5 in the same section, wide resection of the primary tumor with elective neck dissection should be recommended.

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Section: Discussionmentioning

confidence: 99%

Tumor budding is an independent prognostic marker in early stage oral squamous cell carcinoma: With special reference to the mode of invasion and worst pattern of invasion

et al. 2018

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“…High correlation has been reported of tumour measurements between MRI and pathology in literatures (Geol et al., 2016; Imai et al., 2017; Jung et al., 2009; Kwon et al., 2016; Lam et al., 2004; Preda et al., 2006). The difference of values measured between the two methods needs to be evaluated.…”

Section: Introductionmentioning

confidence: 93%

Assessing the magnetic resonance imaging in determining the depth of invasion of tongue cancer

Zhu

et al. 2020

Oral Diseases

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Objectives To assess the magnetic resonance imaging (MRI) in predicting tumour's depth of invasion (DOI) of tongue cancer by comparing to pathology and to determine the cut‐off value of MRI‐derived DOI for lymph node metastasis. Patients and methods In a retrospective analysis, 156 patients with newly diagnosed tongue cancer were included. Tumour's DOI was compared between MRI measurement and pathology by Pearson correlation coefficient and paired t test. The accuracy of MRI‐derived DOI was compared to the pathological DOI. The relationship between MRI‐derived DOI and cervical lymph node metastasis was calculated by receiver operating characteristic curve. Results Tumour's DOI was well correlated between MRI measurement and pathology with correlation coefficients of 0.77. MRI‐derived DOI was 3.4 mm (28%) larger than pathology. The accuracy of MRI in deciding pathological DOI was 67.9%. The cut‐off value of MRI‐derived DOI was 10.5 mm for lymph node metastasis of tongue cancer. Conclusion Magnetic resonance imaging can be used as a reference to determine tumour's DOI of tongue cancer. Tumour with MRI‐derived DOI larger than 10.5 mm deserves simultaneous neck dissection at initial surgery.

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“…However, the reported occult metastasis rate varies based on race and geographical differences (4)(5)(6)(7), and a few authors have noted that a wait-and-see policy does not compromise survival (4,5). Further, the shoulder pain and dysfunction associated with neck dissection, although uncommon, should not be neglected (8).…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of Occult Metastasis and Survival Significance of Metabolic Tumor Volume Determined by PET-CT in cT1-2N0 Squamous Cell Carcinoma of the Tongue

Yang

Liu

et al. 2020

Front. Oncol.

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ObjectivesOur goal was to analyze the possibility of using metabolic tumor volume (MTV) to predict occult cervical metastasis and survival in cT1-2N0 squamous cell carcinoma (SCC) of the tongue.MethodsData on the primary tumor MTV and cervical node status as determined by the maximum standardized uptake value were retrieved. The sensitivity and specificity in predicting occult metastasis were calculated with a fourfold table. Associations between occult metastasis and clinicopathological variables were evaluated by univariate and multivariate analyses. The main study endpoints were locoregional control (LRC) and disease-specific survival (DSS).ResultsA total of 24 (20.3%) of 118 patients had occult metastasis. An MTV cutoff value of 4.3 cm3 showed a sensitivity of 50.0% and a specificity of 76.6% in predicting occult metastasis. The sensitivity and specificity of PET-CT in predicting occult metastasis in cT1 tumors were 66.6 and 89.8%, respectively, with values of 83.3 and 67.3%, respectively, when combined with the MTV. The sensitivity and specificity of PET-CT in predicting occult metastasis in cT2 tumors were 72.2 and 82.2%, respectively, with values of 88.9 and 57.8%, respectively, when combined with the MTV. Patients with MTV ≥4.3 cm3 had a higher occult metastasis rate than patients with MTV <4.3 cm3. The 5-year LRC and DSS rates were 86 and 94%, respectively, in patients with MTV <4.3 cm3 and 54 and 72%, respectively, in patients with MTV ≥4.3 cm3. Both differences were found to be significant in univariate and multivariate analyses.ConclusionsMTV ≥4.3 cm3 was associated with an increased probability of occult metastasis and lower LRC and DSS rates in early-stage SCC of the tongue.

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Retrospective observational study of occult cervical lymph-node metastasis in T1N0 tongue cancer

Cited by 32 publications

References 21 publications

Tumor budding is an independent prognostic marker in early stage oral squamous cell carcinoma: With special reference to the mode of invasion and worst pattern of invasion

Tumor budding is an independent prognostic marker in early stage oral squamous cell carcinoma: With special reference to the mode of invasion and worst pattern of invasion

Assessing the magnetic resonance imaging in determining the depth of invasion of tongue cancer

Predictive Value of Occult Metastasis and Survival Significance of Metabolic Tumor Volume Determined by PET-CT in cT1-2N0 Squamous Cell Carcinoma of the Tongue

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