Patterns of cervical metastasis from carcinoma of the oral tongue (original) (raw)

Frequency of Cervical Nodal Metastasis in Early-Stage Squamous Cell Carcinoma of the Tongue

International Archives of Otorhinolaryngology

Introduction Oral cavity carcinoma is an aggressive tumor, with the tongue being one of the most common subsites of involvement. Surgery is a gold standard method of dealing with advanced-stage tumors. However, for early-stage carcinomas of the tongue, the management remains controversial. Several studies have indicated that early-stage cancers have a high chance of occult cervical node metastasis, which, if left untreated, can greatly affect the prognosis. Certain parameters can help identify patients with occult cervical node metastases, and can avoid unnecessary neck dissection in node negative patients. Tumor thickness is one such objective parameter. Objective To estimate the frequency of cervical lymph node metastasis in patients with early-stage, node-negative (N0) squamous cell carcinoma of the tongue. Methods In-patient hospital data was reviewed from January 2013 until March 2014, and 78 patients who underwent primary resection of the tumor and neck dissection for biopsy-p...

Risk factors for late cervical lymph node metastases in patients with stage I or II carcinoma of the tongue

Head & Neck, 2002

Background. Many histopathologic parameters in squamous cell carcinoma of the tongue have been identified as predictive factors for cervical lymph metastasis. However, predictive factors for occult cervical lymph node metastases and the criterion for elective therapy remain inconclusive. This study analyzed the clinicopathologic factors associated with late cervical lymph node metastases in patients with carcinoma of the tongue.

Depth of Invasion as a Predictor of Cervical Nodal Metastasis of Oral Tongue Squamous Cell Carcinoma: Findings From a Tertiary Care Center in Pakistan

Cureus, 2021

Background and objective Cervical lymph node metastasis has a significant impact on the survival of patients with oral cavity tumors. The rate of occult neck node metastasis is reported to range from 20 to 40%. The depth of invasion (DOI) has been incorporated in the eighth edition of the American Joint Commission on Cancer (AJCC) staging manual and is an important predictor of cervical lymph node metastasis. In this study, we aimed to identify the occult neck node metastasis rate in early oral tongue squamous cell carcinoma (OTSCC) and correlate it with the DOI. Methods A retrospective review of all patients presenting to our facility with early-stage OTSCC was performed. Patients with tumor size of ≤4 cm and who underwent elective neck dissection at the time of surgery were included. The study outcomes were the rates of occult neck metastases in T1 and T2 OTSCC and their correlation with the DOI. Results There were 80 patients in total. Occult neck node metastases were seen in 29 (36.25%) patients. Patients with a DOI >5 mm were 1.41 times more likely to have occult neck node metastasis than those with a DOI ≤5 mm. Conclusion Occult neck node metastasis is significantly associated with the DOI. The risk of neck metastasis is higher in patients with a DOI >5 mm.

Predictive Markers for Late Cervical Lymph Node Metastasis in Patients with N0 Squamous Cell Carcinoma of the Tongue

Asian Journal of Oral and Maxillofacial Surgery, 2006

Objective: To find useful markers for predicting late cervical metastasis in patients with N0 squamous cell carcinoma of the tongue. Patients and Methods: The clinicopathological features of 57 consecutive patients with previously untreated N0 squamous cell carcinoma of the tongue were reviewed. Thirty patients had T1 disease, 20 had T2 disease, and 7 had T3 disease. All patients were treated with partial glossectomy without elective neck dissection. Clinicopathological factors were analysed to determine the factors predicting late cervical lymph node metastasis. Results: The overall cervical lymph node metastasis rate was 19.3%. The clinicopathologic factors significantly associated with the development of cervical lymph node metastasis were tumour size (30 mm), tumour depth (4 mm), differentiation (moderate), mode of invasion (G4C, 4D), microvascular invasion (present), muscle invasion (present), and invasive front grading (12 points). In a multivariate logistic regression analysis, invasive front grading ≥12 points in squamous cell carcinoma of the tongue with a tumour depth ≥4 mm had predictive value for late cervical lymph node metastasis.

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

Bangladesh Journal of Otorhinolaryngology, 2021

Background: Carcinoma of oral tongue is the most common oral cancer and because of its structure and function is prone for early local and regional spread of cancer. The final outcome of a primary tongue carcinoma patient depends upon various prognostic factors like thickness of tumor, depth of invasion, size of lesion and neck node 67metastasis. Risk of metastasis and spread to neck nodes increases with increase in tumor thickness Methods: This prospective observational study was carried out in the Department of OtolayngologyHead & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka for 18 months. Thirty patients with early oral tongue carcinoma i.e.T1 & T 2 as per UICC and AJC criteria were included in this study by purposive non-randomized sampling technique. Result of the study were expressed as mean, standard deviation (+SD), frequency and percentages. Unpaired Student’s t-test and Pearson’s correlation co-efficient (r) test were performed. Results: Result ...

Patterns of Neck Node Metastasis in Carcinoma of Oral Cavity

Bangladesh Journal of Otorhinolaryngology, 2020

Objectives: To find out the patterns of cervical lymph node metastasis in oral cavity carcinoma. Methods: This is across sectional study which was carried out in the department of Otolaryngology & Head Neck Surgery Dhaka Medical College Hospital (DMCH), Sir Salimullah Medical College Hospital (SSMC), Bangabandhu Sheikh Mujib Medical University (BSMMU) and National Institute of Cancer Research & Hospital (NICRH) from July 2013 to December 2014.Total 96 cases were included in this study. Data were collected by detail history, clinical examination, relevant investigation and result were processed manually and analyzed with the help of SPSS. Results: In this study 72 (75%) patients presented with clinically palpable neck nodes and 24 (25%) presented without neck node. Among 24 cases 7 cases was radiologically positive neck node. Out of 96 cases stage III was the highest (50.96%) followed by stage IV (27.01%), stage II (13.52%) and stage I (8.32%). That is 23 (23.92%) patients present wi...

Evaluation of neck node metastasis from oral cancer in an Indian population: A comparative pilot study

Ibnosina Journal of Medicine and Biomedical Sciences, 2010

Introduction: Cervical node metastasis in oral cancer is an indicator of advanced disease. It is therefore important to evaluate neck node involvement as a predictor of progression and treatment planning.Materials & Methods: Eleven patients with age range between 38 to 63 years (median age 54 years) undergoing neck dissection simultaneously with the resection of primary intraoral squamous cell carcinoma formed the basis of the present study. A pre-operative assessment of neck by clinical examination, ultrasonography and computed tomography scan was done, which was then compared to the histopathological assessment. The histopathological examination formed the reference.Results: The percentage of sensitivity by clinical examination was 46%. The percentage of sensitivity by ultrasonogram was 69%. The percentage of sensitivity by computed tomography (CT scan) was 85%. These were against the histopathological examination.Conclusion: The study reported an error of almost 50% for the clini...

Patterns of cervical lymph node metastases in oral tongue squamous cell carcinoma: implications for elective and therapeutic neck dissection

The Journal of Laryngology & Otology, 2014

Objectives:To determine the patterns of lymph node metastases in oral tongue carcinomas, and examine the implications for elective and therapeutic neck dissection.Method:The study entailed a retrospective analysis of 67 patients with previously untreated oral tongue squamous cell carcinoma who had undergone simultaneous glossectomy and neck dissection.Results:Of the 40 clinically node-negative patients, 7 patients had metastatic lymph nodes on pathological examination. No occult metastasis was found at level IV. Of the 27 clinically node-positive patients, the incidence rate of level IV metastasis was 11.1 per cent (3 out of 27 patients). No ‘skip metastases’ were found at level IV. Level IV metastases were significantly related to clinically staged nodes categorised as over 2a (p = 0.03) and metastasis to level III (p = 0.01).Conclusion:Routine inclusion of level IV in elective neck dissection is not necessary for clinically node-negative patients with oral tongue squamous cell car...

Tumor Thickness and Cervical Nodal Metastasis in N 0 Oral Tongue Squamous Cell Carcinoma Patients: A Prospective Study

SciDoc Publishers, 2021

Background: Tumor Thickness (TT) plays an important role in the progress and prognosis of malignant tumors in general and oral squamous cell carcinoma in particular. Many studies have concluded that thicker tumors were associated with higher incidence of regional lymph node metastasis and as a result were associated with more lower survival rates. Aim of Study: This study aimed to evaluate relation between tumor thickness (TT) and regional lymph node metastasis in oral tongue squamous cell carcinoma patients, and to evaluate (TT) as a prognostic factor for lymph node metastasis and as an influencer in the suggested treatment plan. Materials and Methods: The study sample contained 40 patients (23 male, 17 female), who were diagnosed with stage I/II oral tongue squamous cell carcinoma. A surgical procedure for tumor excision and an excisional biopsy was performed. The tumor thickness was measured by one pathologist and the regional lymph nodes status was evaluated pathologically or radiologically or by the two methods. The study sample was divided into three groups according to tumor thickness: TT<3mm, TT (3-6mm), and TT>6mm, and the incidence of regional node metastasis in the three studied thickness groups was calculated. Tumor thickness values were compared in cases of positive regional lymph node involvement and negative regional node involvement using t-test.