TNM Classification: Are Cancers With Extrinsic Tongue Muscle Involvement Systematically T4a?

Touré, Gaoussou; Vlavonou, Sandrine; Andrianantoandro, Iavosoa; Ndiaye, M.

doi:10.1016/j.joms.2020.07.222

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…The primary goal of tumor ablation in OTSCC is to remove the entire tumor along with a “margin” of normal tissue. Inadequate clearance of tumor cells results in increased risks of local and regional recurrences, as well as decreased long-term survival rates ( 11 , 12 ).…”

Section: Discussionmentioning

confidence: 99%

Subtotal glossectomy with conservation of the hyo-styloglossus unit (HSU): a new pivotal concept for preserving tongue function in extended glossectomy

Gazzini,

Caselli,

Dallari

et al. 2024

Front. Surg.

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ObjectiveThe local spread of oral tongue squamous cell carcinoma (OTSCC) follows pathways of dissemination along areas of lesser resistance. In more advanced scenarios, the tumor can extend beyond the hemi-tongue of origin, by passing through the lingual septum and following the fibers of the transverse muscle. This can lead to the invasion of the contralateral extrinsic muscles, the first being the genioglossus and more laterally the hyoglossus. An anatomically guided surgical resection of the tumor can be planned to ensure both oncological safety and an acceptable functional outcome. This approach aims to preserve the hyo-styloglossus unit (HSU) whenever feasible.MethodsBetween January 2019 and November 2022, six patients received extended glossectomy Type B (EG Type B), with preservation of the HSU. Preliminary oncological results and functional results in terms of swallowing (FOIS score) and quality of life (MDADI) are presented.ResultsFive out of the six patients are alive and disease-free, while one patient died due to other causes. All patients who were candidates for an EG Type B underwent a swallowing assessment prior to surgery and followed daily postoperative swallowing training. At discharge, the patients continued swallowing training in an outpatient clinic. Five out of the six patients reached a full oral diet within 1 year of follow-up.ConclusionThe oncological results confirm the safety of this technique. The importance of preserving the HSU, the minimal functional unit, shows very encouraging results in terms of swallowing rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Subtotal glossectomy with conservation of the hyo-styloglossus unit (HSU): a new pivotal concept for preserving tongue function in extended glossectomy

Gazzini,

Caselli,

Dallari

et al. 2024

Front. Surg.

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Palatoglossus Muscle and T4 Category in the Eighth Edition of TNM Staging System for OPSCC

Tirelli,

Gardenal,

Polesel

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveThe present study challenges the appropriateness of considering invasion of the palatoglossus muscle (PGM) as a criterion for staging oropharyngeal squamous cell carcinoma (OPSCC) as T4.Study DesignRetrospective observational study.SettingTertiary University Hospital.MethodsThis retrospective study included nonmetastatic OPSCC patients treated with curative intent at the University of Trieste, Italy from 2015 to 2021. Patients were categorized into 4 groups: (1) tumors classified as T1‐T2 by both International Cancer Control (UICC) and American Joint Committee on Cancer (AJCC)‐TNM; (2) T1‐T2 tumors upgraded to T4 solely by UICC due to oropharyngeal PGM infiltration; (3) T1‐T2 tumors upgraded to T4 by both UICC and AJCC due to oral PGM infiltration; (4) tumors classified as T3‐T4 by both UICC and AJCC. Kaplan‐Meier analysis estimated overall survival (OS) and disease‐free survival (DFS). Multivariable Cox models, adjusted for clinical factors, assessed the impact of palatoglossus invasion on outcomes over 5 years.ResultsA total of 121 consecutive patients with primary OPSCC were included (median [interquartile range] age 65 years [58‐74]; 63% male). While patients with upgraded T4 category due to infiltration of the oral portion of the PGM exhibited a prognosis superimposable on that of other patients with advanced stage disease, those with upgraded T4 category due to infiltration of the oropharyngeal portion of the PGM displayed OS and DFS comparable to T1‐T2 patients.ConclusionOur findings highlight that invasion of the oropharyngeal portion of the PGM may not be a suitable criterion for staging OPSCC as T4. Further research involving larger and independent patient cohorts is strongly encouraged to corroborate these observations.

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Beyond the boundaries of compartmental hemiglossectomy: a proposal for an anatomically based classification of surgical approaches to advanced oral tongue squamous cell carcinoma

Gazzini

Fazio

Dallari

et al. 2023

Eur Arch Otorhinolaryngol

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TNM Classification: Are Cancers With Extrinsic Tongue Muscle Involvement Systematically T4a?

Cited by 3 publications

References 7 publications

Subtotal glossectomy with conservation of the hyo-styloglossus unit (HSU): a new pivotal concept for preserving tongue function in extended glossectomy

Subtotal glossectomy with conservation of the hyo-styloglossus unit (HSU): a new pivotal concept for preserving tongue function in extended glossectomy

Palatoglossus Muscle and T4 Category in the Eighth Edition of TNM Staging System for OPSCC

Beyond the boundaries of compartmental hemiglossectomy: a proposal for an anatomically based classification of surgical approaches to advanced oral tongue squamous cell carcinoma

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