Histopathological factors affecting nodal metastasis in tongue cancer: analysis of 94 patients in Taiwan

Chia

et al. 2012

ORL

Purpose: Staging for tongue carcinoma does not consider its depth of invasion. We aim to determine the prognostic significance of invasion depth in tongue cancer. Materials and Methods: Retrospective review of patients with tongue carcinoma who underwent curative surgery between 2002 and 2005; 67 patients were analyzed. Tumors were divided into 2 groups: group A = invasion depth <4 mm; group B = invasion depth ≥4 mm. Recurrence and survival rates were calculated for each group and compared. Results: The local recurrence rate in group B was significantly higher (10 vs. 29.7%, p = 0.048). Group A patients had a superior 5-year overall survival (68.8 vs. 41.6%, p = 0.012), disease-specific survival (67.1 vs. 41.1%, p = 0.026) and local recurrence-free survival (89.5 vs. 65.4%, p = 0.035). Five-year regional recurrence, locoregional recurrence and distant recurrence-free survival rates were not significantly different between the 2 groups (p = 0.390, p = 0.173 and p = 0.207). The impact of invasion depth on survival was maintained on multivariate analysis (p = 0.031). Conclusion: Invasion depth is an important prognostic indicator in tongue cancer.

Section: Discussionmentioning

confidence: 99%

“…1). Various studies have proposed different cut-off values for tumor invasion depth ranging from 2 to 5 mm [5,8,11,12,13,14,15]. In our study, 4 mm was chosen as the cut-off value for the 2 groups as that was the value recommended in 4 other publications [4,8,12,13].…”

Section: Methodsmentioning

confidence: 99%

Prognostic Significance of Invasion Depth in Oral Tongue Squamous Cell Carcinoma

Chia

et al. 2012

ORL

“…Perineural invasion is a condition in which tumor cells spread along the perineural area. Clinically, this is related to neck metastasis, local recurrence, regional recurrence, distant failure and worse survival rates [41][42][43][44][45][46][47][48]49]. National Comprehensive Cancer Network guidelines recommend adjuvant therapy for patients exhibiting any perineural invasion over the tumor mass, although treatment remains controversial for cases of free margin and negative nodal metastasis.…”

Section: Role Of Lymphovascular Invasion and Perineural Invasion In Ocsccmentioning

confidence: 99%

“…An independent prognostic factor in survival [21][22][23] Tumor size A larger primary tumor increased the chance of local failure and neck metastasis [14,28,29] Surgical margin Adequate surgical margin increases the chances of a good clinical outcome in terms of local and regional control, and survival [35] Perineural invasion Related to neck metastasis, local recurrence, regional recurrence, distant failure and worse survival rates [41][42][43][44][45][46][47][48][49] Genetic instability Deletions of chromosome 3p, 5q and 9p, with 3q gain in well-differentiated tumors are associated with tumor progression Loss of heterozygosity at chromosome regions 3p, 9q and 17p is associated with malignant transformation [58,61] Growth receptor Overexpression of TGF-a or EGFR in tumor cells was related to a worse prognosis [65] Growth factor Overexpression of OPN in tumor cells was related to tumor progression and worse prognosis [75][76] Signal transducers and activators of transcription STAT3 expression was positively correlated with lymph node metastasis and poor prognosis [85] Cell cycle regulators Increased expression of cyclin D was associated with neck nodal metastases, advanced tumor stage and a worse prognosis Cyclin A overexpression was associated with tumor progression and prognosis [90,91] Tumor suppressors pRb overexpression correlated with the presence of metastasis and a worse survival p53 gene mutations may be predictors of recurrence Low p27 expression had positive correlation with high-grade tumors, advanced T stages, positive cervical nodal status and shorter survival Methylation of p16 is frequently found in oral cancer and is associated with malignant progression of oral mucosa dysplasia p16 methylation is used as a maker for prognostic prediction in oral cancer [105,108,112,[114][115] Adhesion CD44 overexpression is associated with metastasis and a poorer prognosis Integrins play a role in tumor cell proliferation, growth, differentiation and migration [117,118] Angiogenesis Ang...…”

Section: Future Perspectivementioning

confidence: 99%

Clinical, Pathological and Molecular Determinants in Squamous Cell Carcinoma of the Oral Cavity

et al. 2010

Squamous cell carcinoma of the oral cavity (OCSCC) is the most frequently observed form of head-and-neck cancer in Southeast Asia and is the sixth most common cancer worldwide. Most cases of this preventable disease are caused by alcohol consumption, smoking and betel nut chewing. The survival rates of patients with advanced OCSCC have not increased significantly in recent years. While treatments for OCSCC are similar worldwide, survival rates differ by geographical area. The various genetic profiles and individual genetic susceptibility for carcinogens may account for this discrepancy. In some respects, molecular alteration or accumulation affects tumor progression and the clinical outcomes among patients with OCSCC. Clarifying the tumor behavior of oral cancer, with regard to pathological features or molecular aspects, could help clinicians to judge, tailor and adopt more effective therapeutic strategies to treat oral cancer.

Australian Dental Journal

“…Tongue carcinomas have a higher incidence of cervical lymph node metastasis than other oral sites, the presence and extent of these being a major determinant of outcome, 1 correlating with the depth of invasion of the primary neoplasm, rather than with tumour size per se. [2][3][4][5] Matrix metalloproteinases (MMPs) are zinc-dependent endopeptidases which cleave extracellular matrix (ECM) molecules. It is necessary for cancer cells to acquire this ability to become invasive.…”

Section: Introductionmentioning

confidence: 99%

Immunoexpression of matrix metalloproteinase‐2 and matrix metalloproteinase‐9 in the metastasis of squamous cell carcinoma of the human tongue

Zhou

Gao

Johnson

et al. 2010

Background: Squamous cell carcinoma of the tongue has frequent lymph node metastases and poor prognosis. Matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) are reported to degrade basement membrane, facilitating invasion and metastasis. This study determined the expression of MMP-2 ⁄ MMP-9 in primary tongue cancer with or without cervical metastases and analysed the significance of such expression in relation to the presence or absence of metastases. Methods: Expressions of MMP-2 ⁄ MMP-9 were detected by immunohistochemistry in 10 specimens of normal oral mucosa, 20 lymph node-negative tongue cancers, 41 lymph node-positive tongue cancers and their metastasized tumours in cervical lymph nodes. Results: MMP-2 ⁄ MMP-9 expression was seldom found in normal epithelium. In lymph node-negative tongue cancer, 45% and 40% of these primary tumours were positively stained for MMP-2 ⁄ MMP-9, respectively. Importantly, in lymph node-positive tongue cancer, 71% and 79% of these primary tumours were positive for MMP-2 ⁄ MMP-9, respectively. Overexpression of MMP-2 ⁄ MMP-9 was present in the metastatic lymph nodes. Conclusions: Our results imply that MMP-2 and ⁄ or MMP-9 play an important role in invasion and metastasis in tongue cancer, and that analysis of MMP expression and ⁄ or activity in primary tumours may have a predictive value for the actual or potential presence of cervical metastases.