Deepak Balasubramanian1, Ardalan Ebrahimi1, Ruta Gupta2, Kan Gao3, Michael Elliott4, Carsten E Palme4, Jonathan R Clark5. 1. Sydney Head & Neck Cancer Institute, The Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW 2050, Australia; Department of Head & Neck Surgery, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia. 2. Sydney Head & Neck Cancer Institute, The Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW 2050, Australia; Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia; Central Clinical School, University of Sydney, NSW 2006, Australia. 3. Sydney Head & Neck Cancer Institute, The Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW 2050, Australia. 4. Sydney Head & Neck Cancer Institute, The Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW 2050, Australia; Department of Head & Neck Surgery, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia; Central Clinical School, University of Sydney, NSW 2006, Australia. 5. Sydney Head & Neck Cancer Institute, The Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW 2050, Australia; Department of Head & Neck Surgery, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia; Central Clinical School, University of Sydney, NSW 2006, Australia. Electronic address: jcjc@tpg.com.au.
Abstract
OBJECTIVES: To identify whether tumour thickness as a predictor of nodal metastases in oral squamous cell carcinoma differs between tongue and floor of mouth (FOM) subsites. MATERIALS AND METHODS: Retrospective review of 343 patients treated between 1987 and 2012. The neck was considered positive in the presence of pathologically proven nodal metastases on neck dissection or during follow-up. RESULTS: There were 222 oral tongue and 121 FOM tumours. In patients with FOM tumours 2.1-4mm thick, the rate of nodal metastases was 41.7%. In contrast, for tongue cancers of a similar thickness the rate was only 11.2%. This increased to 38.5% in patients with tongue cancers that were 4.1-6mm thick. Comparing these two subsites, FOM cancers cross the critical 20% threshold of probability for nodal metastases between 1 and 2mm whereas tongue cancers cross the 20% threshold just under 4mm thickness. On logistic regression adjusting for relevant covariates, there was a significant difference in the propensity for nodal metastases based on tumour thickness according to subsite (p=0.028). CONCLUSION: Thin FOM tumours (2.1-4mm) have a high rate of nodal metastases. Elective neck dissection is appropriate in FOM tumours ⩾2mm thick and in tongue tumours ⩾4mm thick.
OBJECTIVES: To identify whether tumour thickness as a predictor of nodal metastases in oral squamous cell carcinoma differs between tongue and floor of mouth (FOM) subsites. MATERIALS AND METHODS: Retrospective review of 343 patients treated between 1987 and 2012. The neck was considered positive in the presence of pathologically proven nodal metastases on neck dissection or during follow-up. RESULTS: There were 222 oral tongue and 121 FOM tumours. In patients with FOM tumours 2.1-4mm thick, the rate of nodal metastases was 41.7%. In contrast, for tongue cancers of a similar thickness the rate was only 11.2%. This increased to 38.5% in patients with tongue cancers that were 4.1-6mm thick. Comparing these two subsites, FOM cancers cross the critical 20% threshold of probability for nodal metastases between 1 and 2mm whereas tongue cancers cross the 20% threshold just under 4mm thickness. On logistic regression adjusting for relevant covariates, there was a significant difference in the propensity for nodal metastases based on tumour thickness according to subsite (p=0.028). CONCLUSION: Thin FOM tumours (2.1-4mm) have a high rate of nodal metastases. Elective neck dissection is appropriate in FOM tumours ⩾2mm thick and in tongue tumours ⩾4mm thick.
Authors: Giuseppe Troiano; Vito Carlo Alberto Caponio; Linda Boldrup; Xiaolian Gu; Lorenzo Lo Muzio; Nicola Sgaramella; Lixiao Wang; Karin Nylander Journal: Oncotarget Date: 2017-08-21
Authors: R K De Silva; B S M S Siriwardena; A Samaranayaka; W A M U L Abeyasinghe; W M Tilakaratne Journal: PLoS One Date: 2018-08-09 Impact factor: 3.240
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