Evaluation of Microscopic Disease in Oral Tongue Cancer Using Whole-Mount Histopathologic Techniques: Implications for the Management of Head-and-Neck Cancers

Cardiac metastasis from a primary head and neck cancer is a rare finding. Most patients with cardiac metastases have nonspecific symptoms that may vary depending on the severity and location of the lesion. Due to the infrequency of reported cases, there are no clear guidelines for the diagnosis or management of cardiac metastasis in head and neck cancer patients. In this report, we discuss the case of a patient with a primary diagnosis of oral tongue cancer who developed a cardiac metastasis that was detected antemortem.

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ASSOCIATION OF THE DEPTH OF TUMOR & LYMPHATIC METASTASIS IN ORAL TONGUE CANCER

10.36106/ijsr/5011078 ◽

2020 ◽

pp. 1-4

Author(s):

Vishram Singh Gurjar ◽

D.P. Gupta ◽

Shubhangi Gupta ◽

Nand Kishor Lohar ◽

Shailesh Kumar Jain ◽

...

Keyword(s):

Head And Neck ◽

Lymphatic Metastasis ◽

Tongue Cancer ◽

Neck Region ◽

Nodal Metastasis ◽

Positive Lymph Node ◽

Tumor Thickness ◽

Oral Tongue ◽

Neck Node ◽

Oral Tongue Cancer

Carcinoma of tongue is one of the most notorious cancer of head and neck region. It constitutes about 36.5% of all oral malignancies. Neck node status is the single most important prognostic factor in oral tongue cancers and other head and neck cancers . Another important parameter which has the greatest influence on survival is the tumor thickness especially in carcinoma tongue . In this study, we assessed the association between tumor thickness & lymphatic metastasis in oral tongue cancer. The optimal cut-off point for tumor thickness was 4mm. Total 126 cases were studied of which maximum cases were between 40-49 years of age .Cases were more prevalent in males (69.05%) than females(30.95%) . As the T-stage of cancer progressed , the incidence of nodal metastasis also progressively advanced. It was also observed that as the tumor thickness increased , the proportion of positive lymph node cases also significantly increased. There was significant positive correlation between the tumor thickness measured on MRI and histopathology (r=0.709 , p<0.001)

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Improving Risk Stratification of Early Oral Tongue Cancer with TNM-Immune (TNM-I) Staging System

Cancers ◽

10.3390/cancers13133235 ◽

2021 ◽

Vol 13 (13) ◽

pp. 3235

Author(s):

Alhadi Almangush ◽

Ibrahim O. Bello ◽

Ilkka Heikkinen ◽

Jaana Hagström ◽

Caj Haglund ◽

...

Keyword(s):

Overall Survival ◽

Tongue Cancer ◽

Early Stage ◽

Disease Free Survival ◽

Tumor Infiltrating Lymphocytes ◽

Staging System ◽

Oral Tongue ◽

Oral Tongue Cancer ◽

Important Player ◽

Infiltrating Lymphocytes

Although patients with early-stage oral tongue squamous cell carcinoma (OTSCC) show better survival than those with advanced disease, there is still a number of early-stage cases who will suffer from recurrence, cancer-related mortality and worse overall survival. Incorporation of an immune descriptive factor in the staging system can aid in improving risk assessment of early OTSCC. A total of 290 cases of early-stage OTSCC re-classified according to the American Joint Committee on Cancer (AJCC 8) staging were included in this study. Scores of tumor-infiltrating lymphocytes (TILs) were divided as low or high and incorporated in TNM AJCC 8 to form our proposed TNM-Immune system. Using AJCC 8, there were no significant differences in survival between T1 and T2 tumors (p > 0.05). Our proposed TNM-Immune staging system allowed for significant discrimination in risk between tumors of T1N0M0-Immune vs. T2N0M0-Immune. The latter associated with a worse overall survival with hazard ratio (HR) of 2.87 (95% CI 1.92–4.28; p < 0.001); HR of 2.41 (95% CI 1.26–4.60; p = 0.008) for disease-specific survival; and HR of 1.97 (95% CI 1.13–3.43; p = 0.017) for disease-free survival. The TNM-Immune staging system showed a powerful ability to identify cases with worse survival. The immune response is an important player which can be assessed by evaluating TILs, and it can be implemented in the staging criteria of early OTSCC. TNM-Immune staging forms a step towards a more personalized classification of early OTSCC.

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