Relationship between the appearance of tongue carcinoma on intraoral ultrasonography and neck metastasis

Abstract

Objective To evaluate the usefulness of intraoral ultrasonography (IOUS) as a tool for predicting neck metastasis. Introduction Squamous cell carcinoma (SCC) of the tongue is aggressive and has a great propensity to metastasize to cervical lymph nodes. SCC of the oral cavity has a worse prognosis when associated with metastatic cervical nodes. Therefore, the metastatic potential of tongue carcinoma should be graded preoperatively to help determine the requirement for neck dissection. Methods Nineteen patients (11 men, 8 women) between 36 and 79 years of age (mean age 60) with T1 to T4a TNM-stage tongue carcinomas were evaluated preoperatively with IOUS. Clinical and pathological TNM classifications were performed. Results The average tumor thicknesses measured using histological sections were significantly (p \ 0.01) lower than those with IOUS (1.3 vs. 1.6 cm, respectively).A significant correlation was observed between the tumor thickness measured using ultrasonography and that measured using histological sections (pathology). Based on this greater accuracy, the cutoff point of tumor thickness based on IOUS evaluation for predicting neck metastasis was determined to be 1.8 cm. Discussion Some factors may influence neck metastasis. A knowledge of these would help to avoid unnecessary surgical intervention for N0 patients. The results of this study indicates that there is a significant correlation between neck metastasis and tumor thickness. Conclusion Intraoral ultrasonography is useful tool for identifying tongue tumors and measuring their thickness, with the thickness measured by IOUS showing a very good correlation with histological measurements. Moreover, IOUS provides prognostic information prior to surgical treatment since tumor thickness can predict the chance of recognizing metastatic cervical nodes.

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 .…”

Magnetic Resonance vs. Intraoral Ultrasonography in the Preoperative Assessment of Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

“…All studies compared TT or DOI measured preoperatively or intraoperatively by intraoral US with TT or DOI measured on histopathological slides. A total of 12 studies (n = 520 patients) was included (19,(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38). The sample size ranged from 13 to 109 patients.…”

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

“…Natori et al [7] reported that the shape and pattern of the tumor margin on US were important findings with which to the grade the malignancy of tongue cancer and that diffuse, invasive tumors showed an irregular and unclear margin. Chammas et al [26] classified the tumor margin as well as circumscribed (type 1), moderately clear (type 2), or diffuse and unclear (type 3). Their results show that US provides useful information regarding the shape and extent of tongue cancer.…”