scholarly journals Correlation between histological grading, LVI and PNI of carcinoma oral tongue to lymph node metastasis

2018 ◽  
Vol 5 (1) ◽  
pp. 159
Author(s):  
Sumana C. Viswanatha ◽  
Naveen Hedne ◽  
Suhel Hasan
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Histopathological Examination ◽  
Tongue Cancer ◽  
Tnm Classification ◽  
Primary Tumour ◽  
Nodal Metastasis ◽  
Oral Tongue ◽  
Node Metastasis ◽  
Poorly Differentiated

<p class="abstract"><strong>Background:</strong> Squamous cell carcinoma (SCC) of oral tongue has a higher predisposition to lymph node metastasis which reduces survival by 50%. In clinical practice, TNM classification is used for treatment planning which does not provide information on the biological characteristics of the tumor.</p><p class="abstract"><strong>Methods:</strong> This prospective cross sectional observational study included 30 patients with T1 to T3, N0/+ oral tongue SCC from 1<sup>st</sup> March 2014 to 30<sup>th</sup> April 2015. Incisional biopsy was taken from the primary tumour, pathological evaluation for differentiation of the tumour and assessment of lymphovascular (LVI) and perineural invasion(PNI) was carried out. Post operative histopathological examination included differentiation, LVI and PNI. The pathological findings were correlated using chi square test.  </p><p class="abstract"><strong>Results:</strong> Majority presented with T2 stage. 27% had nodal metastasis. There was higher incidence of lymph node metastasis in moderately differentiated (MD) and poorly differentiated (PD) SCC which was not statistically significant. Significant correlation was seen between LVI and PNI to lymph node metastasis (p≤0.001).</p><p class="abstract"><strong>Conclusions:</strong> There is a higher incidence of lymph node metastasis seen in moderately and poorly differentiated SCC of oral tongue, which can be assessed on the preoperative biopsy, guiding us to be more aggressive in the management of cervical nodes in early tongue cancer.<strong> </strong>LVI and PNI are good predictors of nodal metastasis, help in assessing aggressiveness and prognosis of the disease, and are soft indicators for considering adjuvant / concurrent RT.</p>

Controversies in relation to neck management in N0 early oral tongue cancer

2019 ◽  
Vol 49 (4) ◽  
pp. 297-305 ◽  
Author(s):  
Nobuhiro Hanai ◽  
Takahiro Asakage ◽  
Naomi Kiyota ◽  
Akihiro Homma ◽  
Ryuichi Hayashi
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tongue Cancer ◽  
Early Stage ◽  
Oral Tongue ◽  
Invasive Treatment ◽  
Node Metastasis ◽  
Oral Tongue Cancer ◽  
Prophylactic Neck Dissection ◽  
Occult Lymph Node Metastasis

Abstract The standard local treatment for early-stage tongue cancer with no clinical lymph node metastases is partial glossectomy. The frequency of occult lymph node metastasis is ~20–30%. Thus, whether prophylactic neck dissection with glossectomy or glossectomy alone should be performed has been a controversial issue since the 1980s. Both treatments have advantages and disadvantages; however, especially in cases involving prophylactic neck dissection, surgical invasion and complications including the cosmetic disadvantage caused by neck skin incision, accessory nerve paralysis or facial nerve (mandibular marginal branch) paralysis, stiffness of the shoulder or neck and a feeling of neck tightness have been considered issues that could be solved by providing less-invasive treatment to the 70–80% of patients without occult lymph node metastasis. A more accurate preoperative diagnosis and strict follow-up are required to provide minimally invasive treatment while ensuring the therapeutic effect. It is also necessary to narrow down the target based on the risk–benefit balance. The depth of invasion should be considered in cases involving oral cavity malignancies. This was also taken into account in recent revisions of eighth edition of the TNM Classification of Malignant Tumors and it is an important factor for N0 neck management. This review article summarizes previous and recent reports on neck management, focusing on the risk–benefit and future perspectives of the diagnosis and treatment of early-stage oral tongue cancer. This effort is an attempt to establish treatment from the patient’s point of view, with the patient’s quality of life taken into account.

scholarly journals Lymph node metastasis in extremity chondrosarcomas

2020 ◽  
Vol 09 (01) ◽  
pp. 01-03
Author(s):  
Vineet Kurisunkal ◽  
Ashish Gulia ◽  
Puri Ajay ◽  
Bharat Rekhi
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Primary Tumour ◽  
Prognostic Significance ◽  
Oncological Outcome ◽  
Nodal Metastasis ◽  
Node Metastasis ◽  
Primary Bone ◽  
Nodal Spread ◽  
The Impact

Abstract Bacground: Primary bone sarcomas mainly metastasize through haematogenous route and rarely through lymph nodes due to paucity of lymphatic channels in the bone (1). Nodal spread in chondrosarcoma is extremely rare and there are two reported cases in literature including one previously published by our institute (3, 5). Aims and Objectives: We present a series of chondrosarcoma cases (primary tumour located in the scapula, proximal femur, proximal humerus and pelvis), presenting with lymph node metastasis, treated at our institute. We assessed the oncological outcome of these cases and the impact of nodal metastasis on survival. Materials and Methods: Between January 2006 and December 2015, 243 patients of extremity and pelvic chondrosarcoma were operated at our institute. These cases were retrieved from a prospectively maintained database. Four (1.6%) of these patients developed lymph node metastasis. Clinical and radiological details of these cases were retrieved from electronic medical records and case files. Histopathology of the primary chondrosarcoma lesion and nodal metastasis was reconfirmed by a pathologist specializing in sarcomas. Conclusion: Lymph node metastasis though extremely rare in primary osseous chondrosarcoma, definitely affects their survival adversely. The rarity of the occurrence of lymph node metastasis in primary osseous tumors, especially chondrosarcoma highlights the need for multi institutional studies to pool knowledge and evaluate the prognostic significance and etiopathogenesis of lymph node metastasis in primary bone chondrosarcoma.

Lymph node metastasis of early oral tongue cancer after interstitial radiotherapy

2004 ◽  
Vol 58 (1) ◽  
pp. 139-146 ◽  
Author(s):  
Hideya Yamazaki ◽  
Takehiro Inoue ◽  
Ken Yoshida ◽  
Eiichi Tanaka ◽  
Yasuo Yoshioka ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tongue Cancer ◽  
Oral Tongue ◽  
Interstitial Radiotherapy ◽  
Node Metastasis ◽  
Oral Tongue Cancer

scholarly journals Nodal Volume as a Prognostic Factor in Oral Tongue Cancer with Cervical Lymph Node Metastasis

2021 ◽  
Author(s):  
Rattawut Wiengnon ◽  
worawat rawangban ◽  
Chakkrapong Chakkabatr ◽  
Napadon Tangjaturonrasme
Keyword(s):  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Node Metastasis ◽  
Cervical Lymph Node ◽  
Tongue Cancer ◽  
Cervical Lymph Node Metastasis ◽  
Oral Tongue ◽  
Free Survival ◽  
Node Metastasis ◽  
Oral Tongue Cancer

Objectives Oral tongue cancer is the most prevalent type of oral cavity cancer and presents the worst prognosis. With the use of tumor, lymph node, distant metastasis (TNM) staging system, only the tumor and lymph node size are taken into account. However, several studies have considered the tumor volume as a possible significant prognostic factor of oral tongue cancer with cervical lymph node metastasis. Our study, therefore, aimed to explore the prognostic implications of the relevant nodal volume. Design, Setting and Participants Medical records and imaging (either from computed tomography scan, CT scan or magnetic resonance imaging scan, MRI scan) of 70 patients diagnosed with oral tongue cancer with cervical lymph node metastasis between January 2011 and December 2016 were retrospectively reviewed. Main outcome measures The nodal volume was measured from the imaging using the Eclipse application (Version 15.6.05, Varian company) and was further analyzed for its prognostic implications, particularly on overall survival, disease-free survival, and distant metastasis-free survival. Results From a receiver operating characteristic (ROC) curve analysis, the optimal cut-off value of the nodal volume was 3.95 cm3, to predict the disease prognosis, in terms of overall survival and metastatic-free survival (p= <0.001 and p=0.005, respectively), but not the disease-free survival (p=0.241). For the multivariable analysis, the nodal volume, but not TNM staging, was a significant prognostic factor for distant metastasis (HR=4.5, 95%CI 1.1-17.94, p=0.036 vs p=0.459, respectively). Conclusions In patients with oral tongue cancer and cervical lymph node metastasis, the presence of a nodal volume of 3.95 cm3 was a poor prognostic factor for distant metastasis. Therefore, the lymph node volume from the current imaging protocol may be useful in adjunct with the current staging system to predict the disease prognosis

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