The relationship between primary tumour thicknesses in cancers of the oral cavity to subsequent lymph node metastasis

Abstract

Background: Elective dissection of cervical lymph nodes in oral cavity cancers gives very precious data on its pathological state, judge for adjuvant therapy requirement plus its therapeutic effect but it has its morbidities that cannot be condoned. Tumor thickness (TT) in oral cavity cancers show an increasing value to be one of the most important and reliable factors that have a great relationship to regional node involvement.Methods: Forty-three patients with T1, T2 oral cavity squamous cell carcinoma with clinically and radiologically negative cervical L.Ns underwent elective neck dissection and the relation between the tumor thickness and the nodal metastasis was monitored. Tumor thickness was estimated preoperatively by using the intra-oral ultrasound and confirmed by histopathology postoperatively.Results: Only 12 out of 43 neck dissections (27.9%) showed positive L.Ns metastasis of primary tumor. The excised number of L.Ns ranged from 15 to 31 with mean±SD (21.58±3.59) L.Ns. The (TT) ranged from 1.4 mm to 7.8 mm. Our statistical results showed that there is a cutoff point which was 4 mm where (TT) > 4 mm showed significant results with histologically found positive cervical node metastasis compared to (TT) ≤4 mm specimens.Conclusions: Relationship of tumor thickness to lymph node metastasis was found to be significant as shown by this study. Our results clearly demonstrate that conservative elective neck dissection is indicated in patients with stage I/II oral cavity carcinoma whose tumors are > 4 mm in thickness as they mostly have latent metastasis.

Relationship between Thickness of Early Oral Tongue Carcinoma (T1, T2) with Cervical Lymph Node Metastasis

“…So they suffered more. This finding was in agreement with Fawzy et al (2017) and Zia et al(2017) 16,24 .…”

“…Only 13.3% and 6.7% study subjects had secondary and higher secondary level of education. This finding were agreement with Fawzy et al; 2017 16 .…”

“…This may be due to male subjects are use more tobacco, alcohol, betel nut, betel leaf than female. Almost similar to the findings observed by the various investigators from different countries 16,23,24 .…”

“…We thought the thickness of attack and micro vascular proliferation caused by neoplastic growth might determine proximity to the blood vessels and lymphitic channels, thus facilitating the metastatic process in this study. Almost similar to finding observed at Fawzy et al; 2017 16 .…”

“…Previously this relation of tumor thickness and the metastasis to neck nodes was studied by many authors of different countries [12][13][14][15] . Fawzy et al (2017) demonstrate that conservative elective neck dissection is indicated in patients with stage I/II oral tongue carcinoma whose tumors are >4 mm in thickness as they mostly have latent metastasis 16 . The tongue has characteristic structural features including a high content of muscle bundles and a rich lymphatic network that may influence the properties of tumor spread in it.…”