Depth of Invasion as an Independent Predictor of Survival in Patients of Stage III Squamous Cell Carcinoma of the Oral Tongue

Abstract

Objective: Depth of invasion (DOI) has been incorporated in the new AJCC 8th classification. However, even with this new AJCC classification stage III oral tongue squamous cell carcinoma (OTSCC) remains a heterogenous group. The study aims at finding a discreet group within stage III using DOI as a cut-off of 10 mm.Methods: The institutional database was reviewed from 2012 to 2018 for postoperative stage III OTSCC patients who subsequently received postoperative radiotherapy. Ninety-six patients matched the inclusion criteria. Two groups were created using a DOI cut-off of 10 mm (superficial and deep groups). The groups were analyzed for overall survival (OS) and relapse-free survival (RFS).Results: The baseline and treatment characteristics were comparable between the groups except for the higher number of extensive surgeries, endophytic configuration, pT3 and, DOI in the deep group. For a median follow-up of 40.5 (range: 4-139) months, the median OS and RFS for the superficial group were not reached. The median OS and RFS for the deep group were 101 (range: 73.7-128.3) and 60 (range: 46.6-73.4) months, respectively. The difference was statistically significant for median RFS (P = .008) and trended toward significance for median OS (P = .066) for the superficial group. Multivariate Cox regression analysis showed DOI cut-off as a significant predictor for RFS but not for OS.Conclusion: DOI significantly predicts poor RFS. However, showed a trend toward poor OS. This study hints toward a possibility of sub-dividing stage III OTSCC based on DOI cut-off.

Prognostic and clinicopathological significance of cytocapsular tubes in oral squamous cell carcinoma

“…These findings suggest that CTs might promote local invasion, metastasis and progression of OSCC. In accordance with previous studies, 20–23 depth of invasion was identified as a poor prognostic factor in this patient cohort. Moreover, tumor budding, defined as the individual tumor cells or small clusters of tumor cells at the invasive tumor front, was also recognized as a poor prognostic factor, which was consistent with our previous serial studies 3,5,6 .…”

Accuracy of magnetic resonance imaging in the assessment of depth of invasion in tongue carcinoma: A systematic review and meta-analysis

“…From the 714 records retrieved, 621 records were found to be nonrelevant and excluded after reading the titles and abstract, thus leaving 93 titles for full-text retrieval. Of this, 76 were removed for, using non-MRI modalities for measuring DOI (n = 31),[ 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 ] using MRI for measuring DOI in non-tongue carcinoma (n = 15),[ 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 ] lacking statistical details (n = 10),[ 57 58 59 60 61 62 63 64 65 66 ] using MRI for reasons other than DOI measurement (n = 7)[ 67 68 69 70 71 72 73 ] or measuring TT (n = 7),[ 74 75 76 77 78 79 80 ] not comparing MRI measured DOI (n = 5),[ 81 82 83 84 …”

Single Lymph Node Metastasis and Adjuvant Therapy in Stage III Tongue Cancer

“…2) The 7th American Joint Cancer Committee (AJCC) staging system reflected only tumor size and disease extent for the T classification, but DOI is newly included in the revised 8th AJCC staging system. 3) Also, because extranodal extension (ENE) is newly reflected in the N classification of 8th AJCC staging system, cases of metastatic lymph node (LN) with ENE findings have been upstaged to N2a or N3b. Accordingly, all OTSCC patients classified as stage III do not have ENE findings known as a major risk factor.…”