Estimation of prognosis of tongue cancer using tumor depth and margin shape obtained from ultrasonography

Abstract

Objectives To evaluate the feasibility of using ultrasoundobtained tumor depth (TD) and margin shape (MS) to predict the prognosis of tongue cancer. Methods Fifty-two Japanese patients with tongue cancer who underwent ultrasound examination between 2007 and 2012 were retrospectively evaluated. TD was measured at the deepest portion of the tumor. MS was classified as ''pressure,'' ''wedge-shaped,'' or ''permeated.'' Prognosis was assessed by local recurrence, lymph node metastasis, and overall survival rate. We classified the patients into a good prognosis group and poor prognosis group. Relationships among TD, MS, and patient prognosis were evaluated using Spearman rank correlation. A regression formula to predict prognosis using TD and MS was derived.Results The correlation between TD and MS was significant (Spearman rank correlation q = 0.552, p \ 0.01).Using a structure matrix, we identified the contribution of both predictors from an ultrasound image. The contribution of TD was 0.796, while that of MS was better at 0.906. The prognosis could be predicted using the following regression formula: D ¼ À2:801 þ 0:093x þ 0:872y, where D prognosis (risk probability), x = TD (mm), and y = MS (grade). The average value for good risk probability was -0.254 (standard deviation, 0.962), while that for poor risk probability was 0.566 (standard deviation, 1.08) (p \ 0.05). The cut-off value for classifying cases was -0.00169. Using the formula above, 73.1 % of patients in the poor prognosis group were correctly classified.Conclusions MS and TD are useful predictors of tongue cancer prognosis.

Utility of intraoral ultrasound in managing oral tongue squamous cell carcinoma: Systematic review

“…UTT was the most widely reported metric and was assessed in 10 of the 19 studies . The ability to accurately T stage tumors using dimensions obtained during sonographic examination was also investigated by two of the 19 studies Classification of deep margin shape was also used as a method to study different patterns of invasion by three studies . The categories used to describe different margin shapes, however, varied significantly across the three studies.…”

“…However, when controlled for each other and for tumor thickness and internal echo signal in a multivariate regression, the result is no longer significant. Mattalitti et al also investigated margin shape on US but utilized a different classification scheme. Tumor margin shape was categorized into three grades: 1) pressure shaped, 2) wedge shaped, and 3) permeated shape.…”

“…The shape of the deep margin on US is an interesting topic that has not been well studied in the literature even though the pattern of invasion has been shown to significantly impact local control rates in oral cancer management . Of the three studies in the literature, Mattalitti et al's report seems to be the only one that indicates the usefulness of this measure . Patients with a permeated margin were found to have higher rates of poor prognosis, defined as suffering either local recurrence, regional recurrence, or tumor‐related death within 2 years.…”

“…37 Of the three studies in the literature, Mattalitti et al's report seems to be the only one that indicates the usefulness of this measure. 31 Patients with a permeated margin were found to have higher rates of poor prognosis, defined as suffering either local recurrence, regional recurrence, or tumor-related death within 2 years. Mattalitti et al's findings are interesting, as tumors with a more infiltrative pattern at the deep margin on histopathology are known to have greater rates of LN metastasis and reduced survival.…”

“…9,10,21-28 The ability to accurately T stage tumors using dimensions obtained during sonographic examination was also investigated by two of the 19 studies 29,30 Classification of deep margin shape was also used as a method to study different patterns of invasion by three studies. 27,29,31 The categories used to describe different margin shapes, however, varied significantly across the three studies. A measure of tumor vascularity and vascularity index, as obtained by color Doppler sonography, was also studied as a predictor of metastasis in one study.…”