Marta Filauro1,2,3, Francesco Missale1,4, Filippo Marchi1,3, Andrea Iandelli1, Andrea Luigi Camillo Carobbio5,6, Francesco Mazzola1,2, Giampiero Parrinello1, Emanuele Barabino1,7, Giuseppe Cittadini1,7, Davide Farina8, Cesare Piazza9, Giorgio Peretti1,2. 1. IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy. 2. Interdisciplinary Department of Surgical and Integrated Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy. 3. Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy. 4. Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy. 5. IRCCS Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genoa, Italy. a.carobbio@studenti.unibs.it. 6. Interdisciplinary Department of Surgical and Integrated Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy. a.carobbio@studenti.unibs.it. 7. Department of Diagnostic Radiology, IRCCS Policlinico San Martino, Genoa, Italy. 8. Department of Radiology, University of Brescia, Brescia, Italy. 9. Department of Otorhinolaryngology, Maxillofacial, and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan, University of Milan, Milan, Italy.
Abstract
OBJECTIVE: The first-line therapeutic approach for oral cavity squamous cell carcinoma (OCSCC) is complete surgical resection. Preoperative assessment of depth of invasion (cDOI) is crucial to plan the surgery. Magnetic resonance (MR) and intraoral ultrasonography (IOUS) have been shown to be useful tools for assessment of DOI. The present analysis investigates the accuracy of MR and IOUS in evaluating DOI in OCSCC compared to histological evaluation (pDOI). MATERIALS AND METHODS: Forty-nine previously untreated patients with cT1-T3 OCSCC were reviewed. Nine patients were staged with MR alone, 10 with IOUS alone, and 30 with both MR and IOUS. RESULTS: Mean difference between cDOIMR and pDOI values of 0.2 mm (95% CI - 1.0-1.3 mm) and between cDOIIOUS and pDOI of 0.3 mm (95% CI - 1.0-1.6 mm). Spearman R between cDOIMR and pDOI was R = 0.83 and between cDOIIOUS and pDOI was R = 0.76. Both radiological techniques showed high performance for the correct identification, with the optimum cut-off of 5 mm, of patients with a pDOI ≥ 4 mm and amenable to a neck dissection, with an AUC of 0.92 and 0.82 for MR and IOUS, respectively. CONCLUSION: Both examinations were valid approaches for preoperative determination of DOI in OCSCC, although with different cost-effectiveness profiles and indications.
OBJECTIVE: The first-line therapeutic approach for oral cavity squamous cell carcinoma (OCSCC) is complete surgical resection. Preoperative assessment of depth of invasion (cDOI) is crucial to plan the surgery. Magnetic resonance (MR) and intraoral ultrasonography (IOUS) have been shown to be useful tools for assessment of DOI. The present analysis investigates the accuracy of MR and IOUS in evaluating DOI in OCSCC compared to histological evaluation (pDOI). MATERIALS AND METHODS: Forty-nine previously untreated patients with cT1-T3 OCSCC were reviewed. Nine patients were staged with MR alone, 10 with IOUS alone, and 30 with both MR and IOUS. RESULTS: Mean difference between cDOIMR and pDOI values of 0.2 mm (95% CI - 1.0-1.3 mm) and between cDOIIOUS and pDOI of 0.3 mm (95% CI - 1.0-1.6 mm). Spearman R between cDOIMR and pDOI was R = 0.83 and between cDOIIOUS and pDOI was R = 0.76. Both radiological techniques showed high performance for the correct identification, with the optimum cut-off of 5 mm, of patients with a pDOI ≥ 4 mm and amenable to a neck dissection, with an AUC of 0.92 and 0.82 for MR and IOUS, respectively. CONCLUSION: Both examinations were valid approaches for preoperative determination of DOI in OCSCC, although with different cost-effectiveness profiles and indications.
Entities:
Keywords:
Depth of invasion; Head and neck; Magnetic resonance imaging; Mouth; Neoplasm; Ultrasonography
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