Measuring Depth of Invasion in Early Squamous Cell Carcinoma of the Oral Tongue: Positive Deep Margin, Extratumoral Perineural Invasion, and Other Challenges

Background: Egyptian hospital–based statistics showed that head & neck carcinomas represent 18% of all cancers and mostly diagnosed at advanced stages. Our Clinical Oncology & Nuclear Medicine Department of Mansoura Faculty of Medicine serves a large rural area of the Delta region of Egypt. There is no previous study in our institution that focused on oral tongue carcinoma alone. This study aims in establishing the demographics, treatment outcome and prognostic factors of oral tongue squamous cell carcinoma (SCC).Methods: We retrospectively reviewed data of 50 cases with oral tongue SCC treated in our department from January 2014 to December 2016 to evaluate the demography, pathological characteristics, and therapeutic modalities. We estimated the survival rates during the entire follow-up period by the Kaplan–Meier method. The univariate and multivariate Cox proportional hazards analysis were performed for prognostic factors determination.Results: The median follow-up was 30 months (range: 4-45 months). The 3-year overall survival (OS) and disease-free survival (DFS) rates were 68% and 60% respectively. By univariate analysis, both advanced stages (III, IVA) and depth of invasion >0.5 cm were statistically significant as prognostic factors for 3-year DFS and OS rates. DFS rates were 34% vs. 98% for stage III and IVA vs. stage I and II respectively (p = 0.001); 52% vs. 78% for >0.5 cm vs. ≤0.5 cm depth of invasion (p = 0.003). OS rates were 36% vs. 99% for stage III and IVA vs. stage I and II respectively (p = 0.002); 52% vs. 80% for >0.5 cm vs. ≤0.5 cm depth of invasion (p = 0.001). Multivariate analysis of prognostic factors affecting 3-year DFS and OS rates confirmed the statistical significance of the same 2 factors.Conclusions: The majority of our patients were males below 60 years. Tumors were mainly found at stage III and were moderately differentiated. Vascular invasion and lymphatic permeation were uncommon. Staging and tumor invasion depth significantly affected the outcome. The 3-year OS and DFS were 68% and 60% respectively.

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The Potential of MET Immunoreactivity for Prediction of Lymph Node Metastasis in Early Oral Tongue Squamous Cell Carcinoma

Frontiers in Oncology ◽

10.3389/fonc.2021.638048 ◽

2021 ◽

Vol 11 ◽

Author(s):

Maria J. De Herdt ◽

Berdine van der Steen ◽

Quincy M. van der Toom ◽

Yassine Aaboubout ◽

Stefan M. Willems ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Neck Dissection ◽

Squamous Cell ◽

Predictive Value ◽

Tongue Squamous Cell Carcinoma ◽

Added Value ◽

Occult Metastasis ◽

Depth Of Invasion ◽

Oral Tongue

ObjectiveMET positivity is independently associated with survival in oral squamous cell carcinoma (OSCC). Since MET is a known orchestrator of invasive tumor growth, we investigated its association with LNM in early oral tongue squamous cell carcinoma (OTSCC). As it is recommended by the NCCN to use tumor depth of invasion (DOI) in making decisions on elective neck dissection (END), the results obtained for MET positivity were aligned with those for DOI > 4 mm. The cutoff value used in our institution.MethodsTumor samples from patients who underwent primary tumor resection and neck dissection between 1995 and 2013, were collected from the archives of the Leiden and Erasmus University Medical Center. Immunohistochemistry with D1C2 was performed to identify MET negative (< 10% uniform positivity) and MET positive (≥ 10% uniform positivity) cancers. ROC curve analysis and the Chi-squared test were used to investigate the association of MET positivity with LNM (pN+ and occult). Binary logistic regression was used to investigate the association of MET positivity with LNM.ResultsForty-five (44.1%) of the 102 cancers were MET positive. Ninety were cN0 of which 20 were pN+ (occult metastasis). The remaining 12 cancers were cN+, of which 10 were proven pN+ and 2 were pN0. MET positivity was associated with LNM with a positive predictive value (PPV) of 44.4% and a negative predictive value (NPV) of 82.5% for pN+. For the occult group, the PPV was 36.8% and the NPV was 88.5%. Regression analysis showed that MET positivity is associated with pN+ and occult LNM (p-value < 0.05).ConclusionMET positivity is significantly associated with LNM in early OTSCC, outperforming DOI. The added value of MET positivity could be in the preoperative setting when END is being considered during the initial surgery. For cases with DOI ≤ 4 mm, MET positivity could aid in the clinical decision whether regular follow-up, watchful waiting, or END is more appropriate. Realizing that these preliminary results need to be independently validated in a larger patient cohort, we believe that MET positivity could be of added value in the decision making on END in early OTSCC.

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Management of Deep Margin Involvement and or Perineural Invasion in Cutaneous Squamous Cell Carcinoma in the Head and Neck in a Single Unit: 12 Years’ Experience

Plastic & Reconstructive Surgery Global Open ◽

10.1097/01.gox.0000720504.41246.cb ◽

2020 ◽

Vol 8 (9S) ◽

pp. 43-43

Author(s):

Rong R. Khaw ◽

Kristijonas Milinis ◽

Sasha E. Wilson ◽

Ikechukwu E. Emecheta ◽

Aenone Harper-Machin

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Single Unit ◽

Perineural Invasion ◽

Cutaneous Squamous Cell Carcinoma ◽

Margin Involvement ◽

Deep Margin

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Prognostic value of p53 expression and histopathological parameters in squamous cell carcinoma of oral tongue

The Journal of Laryngology & Otology ◽

10.1017/s0022215100144184 ◽

1999 ◽

Vol 113 (5) ◽

pp. 446-450 ◽

Cited By ~ 25

Author(s):

Ömer Faruk Ünal ◽

Ayse Ayhan ◽

Ali Şefik Hoşal

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Perineural Invasion ◽

Nodal Metastases ◽

Lymphocyte Infiltration ◽

Oral Tongue ◽

Tumour Thickness ◽

P53 Immunoreactivity ◽

Lymphovascular Space Invasion

AbstractThe TNM staging system is helpful but not enough to determine prognosis of the patients with squamous cell carcinoma of the oral tongue. T -stage alone is not suggestive for prediction of occult nodal metastases. For this reason, histopathological examination of 70 patients with squamous cell carcinoma of the oral tongue was done retrospectively. The histological differentiation, tumour thickness, perineural and lymphovascular space invasions, the amount of lymphocyte infiltration and pattern of tumour invasion were examined. Immunohistochemical examination was used to determine p53 immunoreactivity as well. The effect of these histopathological parameters and p53 immunoreactivity on nodal metastases and locoregional recurrence were analyzed using the chi-squared test. In terms of nodal metastases the only statistically significant difference between the two groups was tumour thickness, either <9 mm or >9 mm (p<0.05, χ2 = 17.182). Tumour thickness, perineural invasion, lymphovascular space invasion, the amount of lymphocyte infiltration all correlated statistically with locoregional recurrence (p<0.05, χ2 = 6.293 for tumour thickness; p<0.06, p = 0.054 for perineural invasion; p<0.05, χ2 = 8.689 for lymphovascular space invasion; p<0.05, χ2 = 5.320 for lymphocyte infiltration). The immunoreactivity of p53 correlated significantly with larger primary tumour size (p<0.05, χ2 = 5.440), lymph node metastases (p<0.05, χ2 = 4.093) and with pathological tumour stage (p<0.05, χ2 = 5.713). These results reveal that the above-mentioned histological parameters and p53 determination could be used for handling a specimen from an anterior tongue squamous cell carcinoma.

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