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Correlation between clinical and MRI assessment of depth of invasion in oral tongue squamous cell carcinoma

Correlation between clinical and MRI assessment of depth of invasion in oral tongue squamous cell carcinoma
Correlation between clinical and MRI assessment of depth of invasion in oral tongue squamous cell carcinoma

BACKGROUND: Neck metastasis is the most important prognostic factor in oral cavity squamous cell carcinomas (SCC). Apart from the T- stage, depth of invasion has been used as a highly predictable factor for microscopic neck metastasis, despite the controversy on the exact depth cut off point. Depth of invasion can be determined clinically and radio logically. However, there is no standard tool to determine depth of invasion preoperatively. Although MRI is used widely to stage the head and neck disease, its utility in depth evaluation has not formally been assessed.

OBJECTIVE: To compare preoperative clinical and radiological depth evaluation in oral tongue SCC using the standard pathological depth. To compare clinical and radiological accuracy between superficial (<5 mm) vs. deep invaded tumor (≥5 mm) METHODS: This prospective study used consecutive biopsy-proven oral tongue invasive SCC that presented to the University health network (UHN), Toronto. Clinical examination, radiological scan and appropriate staging were determined preoperatively. Standard pathology reports postoperatively were reviewed to determine the depth of invasion from the tumor specimen.

RESULTS: 72 tumour samples were available for analysis and 53 patients were included. For all tumors, both clinical depth (r = 0.779; p < 0.001) and radiographic depth (r =0.907; p <0.001) correlated well with pathological depth, with radiographic depth correlating slightly better. Clinical depth also correlated well with radiographic depth (r = 0.731; p < 0.001). By contrast, for superficial tumors (less than 5 mm on pathological measurement) neither clinical (r = 0.333, p = 0.34) nor radiographic examination (r = - 0.211; p = 0.56) correlated with pathological depth of invasion.

CONCLUSION: This is the first study evaluating the clinical assessment of tumor thickness in comparison to radiographic interpretation in oral cavity cancer. There are strong correlations between pathological, radiological, and clinical measurements in deep tumors (≥5 mm). In superficial tumors (<5 mm), clinical and radiological examination had low correlation with pathological thickness.

Aged, Biopsy, Carcinoma, Squamous Cell, Female, Head and Neck Neoplasms, Humans, Lymphatic Metastasis, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Prognosis, Prospective Studies, Sensitivity and Specificity, Tongue Neoplasms, Comparative Study, Journal Article
1916-0208
61
Alsaffar, H.A.
28f44c8d-4f99-471d-9538-c64692bc56b3
Goldstein, D.P.
a99959d4-7fad-4905-ae0a-30bb872370f6
King, E.V.
d85e0e8f-7295-4912-9052-646a790d99db
de Almeida, J.R.
bd213be1-c65e-4138-ad43-0335864f138d
Brown, D.H.
7e9d86f9-66e9-420f-a4a2-5b779f349cf1
Gilbert, R.W.
e21f59b4-ba7d-4485-bdec-6ebf7b39e48a
Gullane, P.J.
39d14fff-0048-4094-9d60-f1a6985b8bda
Espin-Garcia, O.
ef4248ef-b978-442d-aba3-225347d4b5f3
Xu, W.
367fce1d-4335-45cc-995c-5aa75de74278
Irish, J.C.
7350af02-856b-41fe-a3ba-aff389fd63dd
Alsaffar, H.A.
28f44c8d-4f99-471d-9538-c64692bc56b3
Goldstein, D.P.
a99959d4-7fad-4905-ae0a-30bb872370f6
King, E.V.
d85e0e8f-7295-4912-9052-646a790d99db
de Almeida, J.R.
bd213be1-c65e-4138-ad43-0335864f138d
Brown, D.H.
7e9d86f9-66e9-420f-a4a2-5b779f349cf1
Gilbert, R.W.
e21f59b4-ba7d-4485-bdec-6ebf7b39e48a
Gullane, P.J.
39d14fff-0048-4094-9d60-f1a6985b8bda
Espin-Garcia, O.
ef4248ef-b978-442d-aba3-225347d4b5f3
Xu, W.
367fce1d-4335-45cc-995c-5aa75de74278
Irish, J.C.
7350af02-856b-41fe-a3ba-aff389fd63dd

Alsaffar, H.A., Goldstein, D.P., King, E.V., de Almeida, J.R., Brown, D.H., Gilbert, R.W., Gullane, P.J., Espin-Garcia, O., Xu, W. and Irish, J.C. (2016) Correlation between clinical and MRI assessment of depth of invasion in oral tongue squamous cell carcinoma. Journal of Otolaryngology - Head and Neck Surgery, 45 (1), 61. (doi:10.1186/s40463-016-0172-0).

Record type: Article

Abstract

BACKGROUND: Neck metastasis is the most important prognostic factor in oral cavity squamous cell carcinomas (SCC). Apart from the T- stage, depth of invasion has been used as a highly predictable factor for microscopic neck metastasis, despite the controversy on the exact depth cut off point. Depth of invasion can be determined clinically and radio logically. However, there is no standard tool to determine depth of invasion preoperatively. Although MRI is used widely to stage the head and neck disease, its utility in depth evaluation has not formally been assessed.

OBJECTIVE: To compare preoperative clinical and radiological depth evaluation in oral tongue SCC using the standard pathological depth. To compare clinical and radiological accuracy between superficial (<5 mm) vs. deep invaded tumor (≥5 mm) METHODS: This prospective study used consecutive biopsy-proven oral tongue invasive SCC that presented to the University health network (UHN), Toronto. Clinical examination, radiological scan and appropriate staging were determined preoperatively. Standard pathology reports postoperatively were reviewed to determine the depth of invasion from the tumor specimen.

RESULTS: 72 tumour samples were available for analysis and 53 patients were included. For all tumors, both clinical depth (r = 0.779; p < 0.001) and radiographic depth (r =0.907; p <0.001) correlated well with pathological depth, with radiographic depth correlating slightly better. Clinical depth also correlated well with radiographic depth (r = 0.731; p < 0.001). By contrast, for superficial tumors (less than 5 mm on pathological measurement) neither clinical (r = 0.333, p = 0.34) nor radiographic examination (r = - 0.211; p = 0.56) correlated with pathological depth of invasion.

CONCLUSION: This is the first study evaluating the clinical assessment of tumor thickness in comparison to radiographic interpretation in oral cavity cancer. There are strong correlations between pathological, radiological, and clinical measurements in deep tumors (≥5 mm). In superficial tumors (<5 mm), clinical and radiological examination had low correlation with pathological thickness.

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Accepted/In Press date: 1 November 2016
e-pub ahead of print date: 22 November 2016
Published date: 22 November 2016
Keywords: Aged, Biopsy, Carcinoma, Squamous Cell, Female, Head and Neck Neoplasms, Humans, Lymphatic Metastasis, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Prognosis, Prospective Studies, Sensitivity and Specificity, Tongue Neoplasms, Comparative Study, Journal Article

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Local EPrints ID: 416945
URI: http://eprints.soton.ac.uk/id/eprint/416945
ISSN: 1916-0208
PURE UUID: 05fe3b38-e2fe-45ea-9366-1847720086c9

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Date deposited: 15 Jan 2018 17:30
Last modified: 22 May 2020 16:33

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Contributors

Author: H.A. Alsaffar
Author: D.P. Goldstein
Author: E.V. King
Author: J.R. de Almeida
Author: D.H. Brown
Author: R.W. Gilbert
Author: P.J. Gullane
Author: O. Espin-Garcia
Author: W. Xu
Author: J.C. Irish

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