Predictive value of tumor thickness in squamous carcinoma confined to the tongue and floor of the mouth

Spiro, Ronald H.; Huvos, Andrew G.; Wong, George Y.; Spiro, Jeffrey D.; Gnecco, Clare; Strong, Elliót W.

doi:10.1016/0002-9610(86)90302-8

Cited by 548 publications

(320 citation statements)

References 13 publications

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“…In the adjusted multivariate analysis also Tumor thickness [5 mm (p = 0.009) and (Tables 3 and 4). Our observations are in accordance with previous reports [20][21][22] and raise the question if multimodality treatment (adjuvant radiation) should be considered in this group of patients with tumor thickness [5 mm.…”

Section: Role Of Tumor Budding In Gbcsccsupporting

confidence: 93%

Prognostic and Predictive Factors in Gingivo Buccal Complex Squamous Cell Carcinoma: Role of Tumor Budding and Pattern of Invasion

Manjula

Augustine

Selvam³

et al. 2014

Indian J Otolaryngol Head Neck Surg

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Invasive tumor front (ITF) is the deepest three to six cell layers or detached tumor cell groups at the advancing edge of the tumor. Tumor budding is defined as presence of isolated single cells or small cell clusters scattered in the stroma ahead of the ITF and is characteristic of aggressive cancer. It is recognized as an adverse prognostic factor in several human cancers like colorectal, oesophageal, laryngeal cancers and more recently tongue cancers. However, the prognostic value of tumor budding has not been reported in GBCSCC. The aim of our study was to evaluate the role of pattern of invasion (POI) at the ITF, Tumor budding and other clinicopathological parameters in predicting nodal metastases and prognosis in GBCSCC. 33 patients with primary GBCSCC were prospectively evaluated at a tertiary care referral centre. Tumor budding and type of POI was examined in detail and data documented. Statistical analyses were carried out to assess the correlation of tumor budding, POI, and other clinicopathologic parameters (stage, grade of the tumor, tumor thickness, PNI, LVI) with nodal metastases and predict prognosis. Cox regression was used for both Univariate and multivariate analysis. Significant predictors of nodal metastases on Univariate analysis were male gender (p = 0.021), smoking (p = 0.046), Tumor budding (p = 0.014) and diffuse infiltrative/worst POI (p = 0.004), where as on multivariate analysis only worst POI was significantly associated with positive lymph nodes (p = 0.004). Presence of nodal metastases (p = 0.01) and tumor thickness [5 mm (p = 0.009) were independent negative prognostic factors on multivariate analysis. Significant single risk factor predictive of positive lymph nodes is worst POI in GBCSCC. Nodal metastases and [5 mm tumor thickness are independent risk factors for disease free survival.

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Section: Role Of Tumor Budding In Gbcsccsupporting

confidence: 93%

Prognostic and Predictive Factors in Gingivo Buccal Complex Squamous Cell Carcinoma: Role of Tumor Budding and Pattern of Invasion

Manjula

Augustine

Selvam³

et al. 2014

Indian J Otolaryngol Head Neck Surg

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“…Elective neck dissection appears to be strongly indicated in any patients with an N0 lesion more than 1.5 mm in thickness Spiro et al [10] 92 Tongue and floor of mouth involvement is negligible and can be omitted in N0 and N1 neck.…”

Section: Resultsmentioning

confidence: 99%

Pattern of Lymphatic Metastasis in Relation to the Depth of Tumor in Oral Tongue Cancers: A Clinico Pathological Correlation

Kumar

Patel

2012

Indian J Otolaryngol Head Neck Surg

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Carcinoma of tongue is one of the most notorious cancers of oral cavity. Multivariate analysis have shown that the parameter with greatest influence on survival is tumor thickness especially in carcinoma tongue. To study the pattern of lymphatic metastasis in oral tongue in relation to the depth of tumor. This is a prospective study of 60 patients over a period of 4 years. Squamous cell carcinoma of anterior twothird (oral tongue) which were managed by upfront surgery were considered in the study. USG tongue was done in a few cases (25 out of 60) but was not a mandatory criteria for inclusion or exclusion of the case. The measurements for depth of invasion were made from surface of mucosa to maximal depth by an ocular micrometer. Frequency, proportions and percentages were used to analyse the data. Out of 15 patients who had tumor thickness less than 5 mm, two had nodal metastasis i.e. 13%, whereas 28 patients out of 45 patients with tumor thickness more than 5 mm had nodal disease i.e. 62%. Out of 60 patients enrolled, 13 (21.66%) lost to follow up by the end of 1 year. Of remaining 47 patients seven (14.89%) presented with recurrence (four nodal and three local), three out of which underwent second surgery and four were referred for palliative care. All the four patients referred for palliative care died within 1 year of surgery. As evident from above study only two patients had positive nodal disease when the depth of the tumor was less than 5 mm. There is no role of observation of neck in carcinoma tongue, however if observation is being planned then preoperative ultrasonography of tongue should be done and tumors more than 5 mm should at least be offered extended supraomohyoid neck dissection. Chance of level V involvement is negligible and can be omitted in N0 and N1 neck.

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“…3,[4][5][6] For example, tumor thickness has been reported to predict survival in patients with oral tongue carcinoma, 7 and tumor shape and other pathologic factors have been reported to predict outcomes in patients with head and neck cancers. [7][8][9] Nevertheless, some pathological malignant grading systems are too complex for use by clinicians, and some are inconsistent. 10 Recently, an increased preoperative concentration of C-reactive protein (CRP) was found to be associated with poorer overall survival in patients with OSCC.…”

Section: Introductionmentioning

confidence: 99%

Pain may predict poor prognosis in patients with oral squamous cell carcinoma

Sato

Yamazaki

Satoh

et al. 2011

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

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Objectives:We have previously reported that the histological mode of invasion of oral squamous cell carcinoma (OSCC) is a significant risk factor for pain. We sought to determine whether pain is a risk factor for poor prognosis in patients with OSCC. Study Design:We evaluated the relationships between overall survival rates (OSRs) and clinicopathological variables, including gender, age, Tand N-stages, pathological findings and pain in 109 consecutive patients with untreated OSCC. Results:Of these 109 patients, 40 (37%) reported spontaneous pain.Univariate analysis showed that the OSR of patients with spontaneous pain was significantly lower than that of patients without pain (p=0.002).Multivariate analysis revealed that spontaneous pain and N-stage were significant independent predictors of OSR. Conclusion:This is the first report showing that spontaneous pain before treatment may be associated with poor prognosis in patients with OSCC.3

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Predictive value of tumor thickness in squamous carcinoma confined to the tongue and floor of the mouth

Cited by 548 publications

References 13 publications

Prognostic and Predictive Factors in Gingivo Buccal Complex Squamous Cell Carcinoma: Role of Tumor Budding and Pattern of Invasion

Prognostic and Predictive Factors in Gingivo Buccal Complex Squamous Cell Carcinoma: Role of Tumor Budding and Pattern of Invasion

Pattern of Lymphatic Metastasis in Relation to the Depth of Tumor in Oral Tongue Cancers: A Clinico Pathological Correlation

Pain may predict poor prognosis in patients with oral squamous cell carcinoma

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