Tumor infiltration depth as a prognostic parameter for nodal metastasis in oral squamous cell carcinoma

Abstract

Oral squamous cell carcinoma (OSCC) has locoregional evolution, with frequent neck involvement. Significant number of studies have been undertaken to assess the parameters for treatment of N0 neck patients with a high likelihood of harboring occult node metastases. Many studies have indicated tumor infiltration depth (or tumor thickness) as one of the most important criteria in determining the further management. Growing evidence in the literature shows that tumor infiltration depth is a reliable parameter for predicting regional node involvement and patient survival in OSCC. The substantial agreement among authors, despite the lack of comparable study groups, of measurement techniques, and cutoff values paradoxically enforced its reliability. Further studies are clearly awaited to reach a consensus on these topics to develop therapy protocols that are also based on this parameter. This article is an attempt to substantiate the use of tumor infiltration depth as a prognostic factor for nodal metastasis in OSCC.

MRI prognostic factors of tongue cancer: potential predictors of cervical lymph nodes metastases

“…However; tongue cancer may vary in shape and growth pattern. Therefore, depth of invasion (represented by para-lingual distance), not merely tumour thickness, is another important prognostic factor 30, 31, 32…”

“…Recent research is directed at establishing important prognostic pre-operative cut-off values for cancer tongue. Some investigators have attempted to define a cut-off point for oral cavity cancer thickness that correlates well with positive lymph nodes spread 30, 31, 32, 33. Yuen et al .…”

“…Some investigators have attempted to define a cut-off point for oral cavity cancer thickness that correlates well with positive lymph nodes spread. 30 , 31 , 32 , 33 Yuen et al . have demonstrated 44% incidence of cervical lymph nodes metastases for tumours having a thickness between 3 mm and 9 mm.…”

Comparison of Intraoperative Sonography and Histopathologic Evaluation of Tumor Thickness and Depth of Invasion in Oral Tongue Cancer: A Pilot Study

“…The uTT was measured from the superficial surface of the tumor to the deepest point of tumor invasion (Fig 4), following a path that is perpendicular to the tongue surface. The uDOI was measured from the level of projected normal mucosal surface 7 /basement membrane adjacent to the tumor to the deepest point of tumor invasion (Fig 4), along a path perpendicular to the tongue surface. Consensus measurements were used for analysis.…”

Radiotherapy as Elective Treatment of the Node-negative Neck in Oral Squamous Cell Cancer

“…An argument for performing an END concurrently with resection of the primary tumour is to keep the total treatment time as short as possible. However, as ERTN can be administered alongside postoperative radiotherapy to the primary tumour site, it will not prolong the total treatment, but instead give the opportunity to decide on the need for adjuvant treatment of the neck when the pathology report from the surgery of the primary tumour is available (5,(8)(9)(10)(11)(12)(13)(14). At the Head and Neck Oncology Centre of the University Hospital in Örebro, the routine treatment of cN0 OSCC has been to use ERTN as the single adjuvant neck treatment, and to do END only in connection with free flap reconstructive surgery.A quality register has been kept since 1988, continuously collecting data on all head and neck cancer patients receiving any treatment at Örebro University Hospital in Sweden,…”