The relationship of primary tumor thickness in carcinoma of the tongue to subsequent lymph node metastasis

Hayashi, T; Ito, Jusuke; Taira, Shuhzou; Katsura, Kouji

doi:10.1038/sj.dmfr.4600615

Cited by 42 publications

(31 citation statements)

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“…These values are better than those previously reported for tumour thickness, which had a sensitivity and specificity for predicting metastases of 64% and 100%, respectively, using a cut-off value of 5 mm and 100% and 61.5%, respectively, using a cut-off value of 3 mm. 5,8 In the present study, there was no significant difference in tumour thickness between patients with and without nodal involvement.…”

Section: Discussionmentioning

confidence: 55%

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Vascularity as assessed by Doppler intraoral ultrasound around the invasion front of tongue cancer is a predictor of pathological grade of malignancy and cervical lymph node metastasis

Yamamoto¹,

Yuasa²,

Okamura³

et al. 2016

Dentomaxillofacial Radiology

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Objectives: To quantitatively evaluate the relationship of vascularity of tongue cancer as demonstrated on intraoral ultrasonography images and tumour thickness with pathological grade of malignancy and the presence of cervical lymph node metastases. Methods: 18 patients with tongue cancer were enrolled in this retrospective study. Using Doppler ultrasonography images of the invasion front of the cancers along the length of their tumour boundaries, three vascular indexes were analysed quantitatively, namely ratio of blood flow signal area within the cancer to whole tumour area (BAR), blood flow signal number ratio (BNR) and blood flow signal width ratio (BWR). The associations between these three indexes and occurrence of cervical lymph node metastasis and pathological grade of malignancy [Yamamoto-Kohama (YK) classification] were assessed. Furthermore, the relationship between tumour thickness and occurrence of cervical lymph node metastasis was evaluated on B-mode intraoral ultrasonography images. Results: There was no significant association between BAR and tumour thickness or occurrence of cervical lymph node metastasis. The BNRs and BWRs of patients with cervical lymph node metastasis were significantly higher than those of patients without nodal involvement. The BWRs of patients with high-grade malignancy (YK-4C) were significantly higher than those of patients with low-grade malignancy (YK-2 or 3). Conclusions: BNR and BWR on the invasion front of the tongue cancer are predictors of pathological grade of malignancy and cervical lymph node metastasis. Dentomaxillofacial Radiology (2016Radiology ( ) 45, 20150372. doi: 10.1259 Cite this article as: Yamamoto C, Yuasa K, Okamura K, Shiraishi T, Miwa K. Vascularity as assessed by Doppler intraoral ultrasound around the invasion front of tongue cancer is a predictor of pathological grade of malignancy and cervical lymph node metastasis. Dentomaxillofac Radiol 2016; 45: 20150372.

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Section: Discussionmentioning

confidence: 55%

“…[1][2][3][4][5] Tumour thickness on intraoral ultrasonography images is reportedly an important predictor of cervical lymph node metastasis and patient outcome. [4][5][6][7][8] Invasion front ratio calculated from the length of the invasive front on intraoral ultrasonography images is related to the histopathological grade.…”

Section: Introductionmentioning

confidence: 99%

Vascularity as assessed by Doppler intraoral ultrasound around the invasion front of tongue cancer is a predictor of pathological grade of malignancy and cervical lymph node metastasis

Yamamoto¹,

Yuasa²,

Okamura³

et al. 2016

Dentomaxillofacial Radiology

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“…Many studies subsequently have shown a strong correlation between the thickness of tumor and lymph node metastasis. Using <3 mm as a cutoff value Yuen et al [22,23].…”

Section: Discussionmentioning

confidence: 99%

Cervical node metastasis in T1 squamous cell carcinoma of oral tongue- pattern and the predictive factors

Vishak

Rohan

2014

Indian J Surg Oncol

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Background The squamous cell carcinoma (SCC) of the oral tongue is a common cancer in India. Elective lymphadenectomy is generally performed in all patients with T2-T4 tumors. In this study we have tried to analyze the pattern and risk factors associated with lymph node metastasis in T1 tongue cancers. Methods A retrospective review of the records of 57 patients undergoing surgery for treatment of T1 sqamous cell carcinoma of oral tongue was carried out. The clinicopatological features of the tumor, pattern of nodal metastasis and the risk factors associated with lymph node metastasis were studied. Results Totally 57 patients with T1 tumor underwent excision of the primary and modified neck dissection (MND). Lymph node metastasis was found in 36.8 % of the patients. Level I to Level II was the commonest site of metastasis. Skip metastasis at level III and IV was found in 8.5 % of the patients and isolated skip metastasis at level IV in 1.5 % of the patients. The risk factors associated with the lymph node metastasis on univariete analysis were; higher grade, tumor size >1 cm and tumor thickness >3 mm. On multivariate analysis only the tumor thickness was found to be a risk factor for the lymph node metastasis (hazard ratio of 21.59). Conclusions T1 sqamous cell carcinoma of tongue is associated with a high incidence of lymph node metastasis. Elective neck dissection should be considered in all patients with tumors more than 3 mm in thickness

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“…Many authors have demonstrated the influence of tumor thickness in tongue cancer on occult cervical nodal metastasis [4][5][6][7][8][9][10][11]. Fakih et al [12] showed greater than 30 % metastasis and neck relapse in early staged tongue cancers with C4 mm in thickness of the tumor.…”

Section: Discussionmentioning

confidence: 99%

Affect on Survival Per Increase in Each Millimeter of Tumor Depth in Tongue Cancer

Gokavarapu

Ahmed

Parvataneni

et al. 2014

Indian J Otolaryngol Head Neck Surg

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The critical tumor depth at which the risk of occult metastasis increases in tongue cancer has been demonstrated as C4-5 mm. Conventional T staging might not be an accurate predictor for survival in situations wherein infiltrative growth pattern is easily overlooked. Thus risk of death associated with increase in tumor depth per millimeter might be useful to understand patient's disease status during follow up. Historical cohorts of patients with pT1N0 and pT2N0 primary squamous cell carcinoma of tongue treated between January 2010 and December 2011 were selected and analyzed in univariate and multivariate cox-regression model to indicate the risk of death associated with an increase in each millimeter of tumor depth. The median period of follow up was 34 months. Total 67 patients fulfilled the above mentioned criteria, among them 11 patients died by the end of study period. The mean (SD) age of the patients studied was 49.7 (12.7) years and their age ranged from 21 to 74 years. Among these 66 % (n = 44) were males. In the univariate log-rank test, margin status (p = 0.016), t-stage (p = 0.018) and increased tumor depth (p \ 0.0001) were risk factors for occurrence of death. When adjusted for other risk factors in the multivariate coxregression model, per one unit increase of tumor depth (mm) there was 1.07 (95 % CI 0.95, 1.21) units increased risk of death. Depth of tumor with increase in each millimeter in tongue cancer appears to be associated with risk of death irrespective of regional lymphatic spread.

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The relationship of primary tumor thickness in carcinoma of the tongue to subsequent lymph node metastasis

Cited by 42 publications

References 0 publications

Vascularity as assessed by Doppler intraoral ultrasound around the invasion front of tongue cancer is a predictor of pathological grade of malignancy and cervical lymph node metastasis

Vascularity as assessed by Doppler intraoral ultrasound around the invasion front of tongue cancer is a predictor of pathological grade of malignancy and cervical lymph node metastasis

Cervical node metastasis in T1 squamous cell carcinoma of oral tongue- pattern and the predictive factors

Affect on Survival Per Increase in Each Millimeter of Tumor Depth in Tongue Cancer

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