Depth of invasion (DOI) as a predictor of cervical nodal metastasis and local recurrence in early stage squamous cell carcinoma of oral tongue (ESSCOT) (original) (raw)
Related papers
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.
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2019
Objectives: Tumor thickness (TT) and tumor depth of invasion (DOI) correlate with the risk of regional lymph node metastases in early oral tongue squamous cell carcinoma (OTSCC). We aimed to determine optimal cut-points to guide elective nodal treatment in early OTSCC. Study Design: 145 patients treated between 1995 and 2012 for histologically proven, OTSCC (<4cm) were included in this retrospective study. The minimum p value method was used to calculate cut-point values of TT and DOI that predicted for nodal disease. The utility of the DOI cut-point value and the 5mm DOI currently used for staging were then compared. Results: Logistic regression analysis demonstrated DOI (p=0.00036) and TT (p=0.0001) were highly correlated with nodal disease and each other. The cut-points that best predicted for nodal disease were 4.5 for DOI and 8mm for TT. There was no difference in utility between DOI of 4.5mm and 5mm. Conclusion: TT and DOI were highly correlated with nodal risk but had different cut-points for prediction. Our findings highlight the need for these parameters to be recognized as discrete entities and reported appropriately. This study supports using the 5mm DOI, currently used for staging, as also the threshold value to guide elective nodal treatment.
International Journal of Research in Medical Sciences
Background: Squamous cell carcinomas of the oral cavity are relatively common among the head and neck cancers. The increasing depth of invasion (DOI) and the microvascular proliferation caused by neoplastic growth might determine proximity to blood vessels and lymphatics, thus facilitating the tumor’s ability to metastasize. The role of tumour DOI as a prognostic parameter for the development of nodal metastases and for the survival of patients with OSCC are important. Aim of the study was to determine the relationship of the DOI of tumor with the neck node metastasis in squamous cell carcinoma of the oral cavity.Methods: This study is conducted in the State cancer institute, Gauhati medical college over a period of 1 year from June 2021 to June 2022 among 100 patients. All patients underwent tumor resection with neck dissection, and the DOI is measured.Results: Out of 100 patients included in the study 66 were males and 34 were females. Maximum number of cases 30% were seen in the ...
Ear, Nose & Throat Journal, 2012
Cervical lymph node metastasis is the most important prognostic factor in patients with head and neck carcinoma. We retrospectively analyzed the effects of three different variables—tumor size, degree of differentiation, and depth of invasion—on the risk of neck node metastasis in 50 adults who had been treated with surgery for primary squamous cell carcinoma of the oral cavity. Primary tumor depth and other pathologic features were determined by reviewing the pathology specimens. Preoperatively, 36 of the 50 patients were clinically N0; however, occult lymph node metastasis was found in 13 of these patients (36.1%). The prevalence of neck node metastasis in patients with T1/T2 and T3/T4 category tumors was 51.5 and 58.8%, respectively. The associations between the prevalence of neck node metastasis and both the degree of differentiation and the depth of invasion were statistically significant, but there was no significant association between neck node metastasis and tumor size. We ...
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...
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: The aims of the study were to know whether the increase in the depth of invasion in oral cavity carcinoma assessed histopathologically and radiologically co-relates with neck node metastasis and to accurately co-relate the radiological thickness at which neck dissection is required.Methods: A retrospective study has been conducted over thirty patients with oral cavity carcinoma (buccal mucosa and tongue) in the time period of April 2018 to December 2018 who were operated in our tertiary care hospital. Results: Depth of invasion is relatable histopathologically and radiologically, is directly proportional to neck node metastasis. Pre-operative radiology is a reliable modality to rule out the need of neck node dissection.Conclusions: Depth of invasion is directly proportional to the incidence of neck node metastasis and pre-operative radiology has been reliable to rule out the need of neck dissection and reduce its morbidity.
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.
Head & neck, 2017
The purpose of this study was to investigate the critical primary tumor depth of invasion in oral squamous cell carcinoma that would lead to a 20% or greater risk of nodal metastasis. An institutional review board approved retrospective review of our head and neck database was performed from 2009 to 2014 and the data were statistically analyzed. Two hundred eighty-six patients with a diagnosis of oral squamous cell carcinoma who met our inclusion criteria underwent primary excision and neck dissection. For a depth of invasion of 1 mm or less, there were no patients with a positive node. From 1.1 mm to 2 mm of depth of invasion, there was 1 of 11 patients (9%) who had at least 1 positive node. At 2.1 mm to 3 mm, 5 of 25 patients (20%) had at least 1 positive node. Depth of invasion and the location of the tumor are 2 important variables to consider when making treatment recommendations to patients with clinical N0 disease. © 2017 Wiley Periodicals, Inc. Head Neck 39: 974-979, 2017.
Frontiers in Oncology, 2021
ObjectiveThe depth of invasion (DOI) is considered an independent risk factor for occult lymph node metastasis in oral cavity squamous cell carcinoma (OCSCC). It is used to decide whether an elective neck dissection (END) is indicated in the case of a clinically negative neck for early stage carcinoma (pT1/pT2). However, there is no consensus on the cut-off value of the DOI for performing an END. The aim of this study was to determine a cut-off value for clinical decision making on END, by assessing the association of the DOI and the risk of occult lymph node metastasis in early OCSCC.MethodsA retrospective cohort study was conducted at the Erasmus MC, University Medical Centre Rotterdam, The Netherlands. Patients surgically treated for pT1/pT2 OCSCC between 2006 and 2012 were included. For all cases, the DOI was measured according to the 8th edition of the American Joint Committee on Cancer guideline. Patient characteristics, tumor characteristics (pTN, differentiation grade, perin...
Clinics of Oncology, 2021
To determine the predictive indexes of late cervical lymph node metastasis in early tongue squamous cell carcinoma (TSCC). We retrospectively analyzed the cases of 25 patients with stage I/II TSCC who had undergone surgical treatment without elective neck dissection. We evaluated the relationships between clinicopathologic factors and the occurrence of late cervical lymph node metastasis. Of the 25 cases, metastasis to the cervical lymph nodes was observed in nine cases (36.0%). The clinicopathological factors associated with late cervical lymph node metastasis were the mode of invasion (MOI, p=0.032), depth of invasion (DOI, p=0.004), and perineural invasion (PNI, p=0.040). A multivariate analysis revealed that only the DOI was an independent predictor of late cervical lymph node metastasis. The combination of the DOI and MOI or the PNI and MOI was significantly correlated with late cervical lymph node metastasis (p=0.004 and p=0.012, respectively). Our findings suggest that combinations of the MOI, DOI, and PNI could be used as an index for predicting late cervical lymph node metastasis in early TSCC.