Tumor thickness predicts cervical metastasis in patients with stage I/II carcinoma of the tongue

Abstract

The current study data indicate that patients with Stage I/II carcinoma of the tongue > 4 mm in thickness are at increased risk for subsequent cervical metastasis. Thus, conservative supraomohyoid neck dissection is indicated in patients with Stage I/II carcinoma of the tongue > 4 mm in thickness.

Predictors of Locoregional Recurrence in T1-2N0 Tongue Cancer Patients

“…In our study, the local recurrence rate of 10.3% was similar to those reported in the literature [5,13,[29][30][31]. Some studies have demonstrated that pathological variables such as DOI, surgical margin, and POI could be reliable parameters for local recurrence in early-stage OTSCC [8][9][10][11][20][21][22][23][24][25][26][27][28][29][30][31]. We observed that a higher incidence of local recurrence was associated with POI, NAC, closed surgical margin, and perineural invasion.…”

“…Huang et al determined the optimal DOI cutoff point of ≥4 mm by meta-analysis for prophylactic neck management [24]; therefore, in this study, DOI was classified as ≥4 and <4 mm. Many previous studies have reported that DOI significantly predicted occult cervical metastases [20][21][22][23][24], and in our study, the regional recurrence rate was higher in patients with DOI ≥4 mm than in those with DOI <4 mm, although the statistical difference was not significant.…”

“…Several studies have demonstrated that DOI had a predictive value for cervical lymph node metastasis in patients with T1-2N0 OTSCC [20][21][22][23][24]; however, controversy exists about the optimal DOI cutoff point for a clinically relevant risk to cervical lymph node metastasis. Huang et al determined the optimal DOI cutoff point of ≥4 mm by meta-analysis for prophylactic neck management [24]; therefore, in this study, DOI was classified as ≥4 and <4 mm.…”

“…Where the epithelium was destroyed (since the majority of the tumor showed ulceration), it was measured after reconstructing a virtual surface. Previous studies demonstrated that DOI ≥4 mm had a predictive value for cervical lymph node metastasis in patients with T1-2N0 OTSCC; [20][21][22][23][24] therefore, in this study, DOI was classified as ≥4 and <4 mm. Likewise, regarding the surgical margin, a large cohort study demonstrated that a pathological margin distance ≤4 mm was significantly associated with locoregional recurrence [25]; therefore, in this study, the status of the surgical margin was classified as >4 and ≤4 mm for the superficial and deep margins, respectively.…”

A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck

“…This is similar to the findings from all the randomized controlled trials in this meta-analysis (Table 4) The depth or thickness of the primary tumor has been shown to be an important factor in neck metastasis, if the tumor depth exceeds 4mm, the risk of developing occult metastasis in the neck is increased to between 38 -70% [8,84,105]. Tumor thickness is therefore an important pathologic factor to identify the patients at greater risk of developing neck node metastasis.…”