Tumor thickness and risk of lymph node metastasis in patients with squamous cell carcinoma of the tongue

Mücke, Thomas; Kanatas, Anastasios; Ritschl, Lucas M.; Koerdt, Steffen; Tannapfel, Andrea; Wolff, Klaus‐Dietrich; Loeffelbein, Denys J.; Kesting, Marco

doi:10.1016/j.oraloncology.2015.11.010

Cited by 37 publications

(29 citation statements)

References 40 publications

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“…Recent research is directed at establishing important prognostic pre-operative cut-off values for cancer tongue. Some investigators have attempted to define a cut-off point for oral cavity cancer thickness that correlates well with positive lymph nodes spread 30, 31, 32, 33. Yuen et al .…”

Section: Discussionmentioning

confidence: 99%

MRI prognostic factors of tongue cancer: potential predictors of cervical lymph nodes metastases

Mourad

Higazi

2019

Radiology and Oncology

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Background This study aimed to evaluate the efficacy of three MR imaging parameters, which are tumour thickness, para-lingual distance and apparent diffusion coefficient (ADC) value for prediction of cervical lymph nodes metastasis in cancer tongue patients. Patients and methods Fifty patients with proved cancer tongue by histopathological examination underwent MRI examination. T1 and T2- weighted MRI, diffusion-weighted images and post-contrast T1 fat suppression sequences were used. Results The patients were classified according to lymph nodes involvement as seen by MRI into two groups. Significant differences between positive and negative nodes groups were observed regarding tumour thickness and para-lingual distance (p-values = 0.008 and 0.003 respectively). ROC curve analyses revealed cut-off values >13.8 mm and ≤ 3.3 mm for tumour thickness and para-lingual distance respectively for prediction of nodes involvement. No significant differences between patients with and without cervical lymph nodes metastasis were found regarding corresponding ADC value of the tumour (p-value = 0.518). Conclusions Para-lingual distance and tumour thickness are factors that could influence pre-operative judgment and prognosis of tongue cancer patients. ADC value of the tumour itself seem not to be a reliable index of cancer progression to regional lymph nodes.

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Section: Discussionmentioning

confidence: 99%

MRI prognostic factors of tongue cancer: potential predictors of cervical lymph nodes metastases

Mourad

Higazi

2019

Radiology and Oncology

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“…For patients with node‐negative early OTSCC, there is conflicting evidence as to whether elective neck dissection or therapeutic neck dissection after nodal recurrence should be performed . As DOI is an independent predictor of lymph node metastasis, inclusion of DOI in the staging system may improve the decision making regarding application of elective neck dissection.…”

Section: Discussionmentioning

confidence: 99%

Prognostic performance of the American Joint Committee on Cancer 8th edition of the TNM staging system in patients with early oral tongue cancer

et al. 2018

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Background The 8th edition of the American Joint Committee on Cancer's (AJCC) staging system for oral cavity cancer incorporates pathological features. We aimed to assess whether these changes results in better risk stratification of patients with early oral tongue squamous cell carcinoma (OTSCC). Methods Overall survival (OS) and disease‐specific survival (DSS) of 244 patients were calculated using the Kaplan‐Meier method. Multivariate analysis with stepwise selection was performed using Cox proportional hazards regression. Results Sixty‐two patients (25%) were upstaged using the 8th edition. Multivariate analysis revealed that overall stage using the 8th edition of the AJCC staging system but not using the 7th edition was a significant predictor for both OS and DSS. The 8th edition had lower Akaike information criterion and improved concordance index values compared with the 7th edition. Conclusion The 8th edition of AJCC allows better risk stratification and more precise counseling of patients with OTSCC who were previously considered at low risk.

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“…24,25 Mücke et al, highlight the importance of tumor thickness as a predictive variable in tongue cancer. 26 Specifically, a cut-off point of 8 mm allowed for a more accurate and statistically precise prediction of lymph node metastasis. Their study was done on 492 patients who had a median follow-up of 70 months with squamous cell carcinomas of the tongue.…”

Section: 17mentioning

confidence: 99%

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

et al. 2017

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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.

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Tumor thickness and risk of lymph node metastasis in patients with squamous cell carcinoma of the tongue

Cited by 37 publications

References 40 publications

MRI prognostic factors of tongue cancer: potential predictors of cervical lymph nodes metastases

MRI prognostic factors of tongue cancer: potential predictors of cervical lymph nodes metastases

Prognostic performance of the American Joint Committee on Cancer 8th edition of the TNM staging system in patients with early oral tongue cancer

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

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