Abstract
Objectives
To evaluate the prognostic value of preoperative radiological findings for nodal recurrence in clinically node-negative (cN0) patients with oral tongue squamous cell carcinoma (SCC).
Methods
The study population consisted of 52 patients with cT1-2N0 oral tongue SCC classified according to the 7th edition of the Union for International Cancer Control (UICC) staging system. The subjects had undergone preoperative radiological examinations, including magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography. All patients were treated with local resection and watchful waiting for neck management. Using an unpaired t test, Pearson’s chi-squared test, and the Kaplan–Meier method, the MRI-derived depth of invasion (DOI), the standardized uptake value (SUV) on FDG-PET, and the T stage according to the 7th and 8th UICC were assessed as prognostic factors.
Results
The MRI-derived DOI was recorded as ≤ 5 mm in 24 patients and > 5 mm in 28 patients. During the follow-up period, nine patients exhibited nodal recurrence, with the MRI-derived DOI being significantly higher in patients with positive than in those with negative (p = 0.011). The SUV was not significant. Five-year cumulative nodal recurrence probabilities were 4.5% for patients with an MRI-derived DOI ≤ 5 mm, while it was 32.1% for > 5 mm (p = 0.013). Although the T classifications were not significant, none of our patients whose T stage according to the 8th UICC was T1 suffered nodal recurrence.
Conclusions
MRI-derived DOI can predict nodal recurrence, while preoperative information may assist in treatment planning for oral tongue SCC.
Similar content being viewed by others
References
Abu-Ghanem S, Yehuda M, Carmel NN, Leshno M, Abergel A, Gutfeld O, et al. Elective neck dissection vs observation in early-stage squamous cell carcinoma of the oral tongue with no clinically apparent lymph node metastasis in the neck: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg. 2016;142:857–65.
D’Cruz AK, Vaish R, Kapre N, Dandekar M, Gupta S, Hawaldar R, et al. Elective versus therapeutic neck dissection in node-negative oral cancer. N Engl J Med. 2015;373:521–9.
McDonald C, Lowe D, Bekiroglu F, Schache A, Shaw R, Rogers SN. Health-related quality of life in patients with T1N0 oral squamous cell carcinoma: selective neck dissection compared with wait and watch surveillance. Br J Oral Maxillofac Surg. 2019;57:649–54.
Weiss MH, Harrison LB, Isaacs RS. Use of decision analysis in planning a management strategy for the stage N0 neck. Arch Otolaryngol Head Neck Surg. 1994;120:699–702.
Ng SH, Yen TC, Liao CT, Chang JT, Chan SC, Ko SF, et al. 18F-FDG PET and CT/MRI in oral cavity squamous cell carcinoma: a prospective study of 124 patients with histologic correlation. J Nucl Med. 2005;46:1136–43.
Murakami R, Uozumi H, Hirai T, Nishimura R, Shiraishi S, Ota K, et al. Impact of FDG-PET/CT imaging on nodal staging for head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2007;68:377–82.
Murakami R, Uozumi H, Hirai T, Nishimura R, Katsuragawa S, Shiraishi S, et al. Impact of FDG-PET/CT fused imaging on tumor volume assessment of head-and-neck squamous cell carcinoma: intermethod and interobserver variations. Acta Radiol. 2008;49:693–9.
Halfpenny W, Hain SF, Biassoni L, Maisey MN, Sherman JA, McGurk M. FDG-PET. A possible prognostic factor in head and neck cancer. Br J Cancer. 2002;86:512–6.
Zhang B, Li X, Lu X. Standardized uptake value is of prognostic value for outcome in head and neck squamous cell carcinoma. Acta Otolaryngol. 2010;130:756–62.
Hustinx R, Smith RJ, Benard F, Rosenthal DI, Machtay M, Farber LA, et al. Dual time point fluorine-18 fluorodeoxyglucose positron emission tomography: a potential method to differentiate malignancy from inflammation and normal tissue in the head and neck. Eur J Nucl Med. 1999;26:1345–8.
Kubota K, Itoh M, Ozaki K, Ono S, Tashiro M, Yamaguchi K, et al. Advantage of delayed whole-body FDG-PET imaging for tumour detection. Eur J Nucl Med. 2001;28:696–703.
Cacicedo J, Navarro A, Del Hoyo O, Gomez-Iturriaga A, Alongi F, Medina JA, et al. Role of fluorine-18 fluorodeoxyglucose PET/CT in head and neck oncology: the point of view of the radiation oncologist. Br J Radiol. 2016;89:20160217.
Lowe VJ, Duan F, Subramaniam RM, Sicks JD, Romanoff J, Bartel T, et al. Multicenter trial of [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography staging of head and neck cancer and negative predictive value and surgical impact in the N0 neck: results from ACRIN 6685. J Clin Oncol. 2019;37:1704–12.
Brierley JD, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours. 8th ed. Chichester, West Sussex, UK: John Wiley & Sons, Inc.; 2017.
Huang SH, Sullivan B. Overview of the 8th Edition TNM classification for head and neck cancer. Curr Treat Options Oncol. 2017;18:40.
Vuity D, McMahon J, Takhiuddin S, Slinger C, McLellan D, Wales C, et al. Is the 8th edition of the Union for International Cancer Control staging of oral cancer good enough? Br J Oral Maxillofac Surg. 2018;56:272–7.
Huang SH, Hwang D, Lockwood G, Goldstein DP, O’Sullivan B. Predictive value of tumor thickness for cervical lymph-node involvement in squamous cell carcinoma of the oral cavity: a meta-analysis of reported studies. Cancer. 2009;115:1489–97.
Ebrahimi A, Gil Z, Amit M, Yen TC, Liao CT, Chaturvedi P, et al. Primary tumor staging for oral cancer and a proposed modification incorporating depth of invasion: an international multicenter retrospective study. JAMA Otolaryngol Head Neck Surg. 2014;140:1138–48.
Sakata J, Yamana K, Yoshida R, Matsuoka Y, Kawahara K, Arita H, et al. Tumor budding as a novel predictor of occult metastasis in cT2N0 tongue squamous cell carcinoma. Hum Pathol. 2018;76:1–8.
Mao MH, Wang S, Feng ZE, Li JZ, Li H, Qin LZ, et al. Accuracy of magnetic resonance imaging in evaluating the depth of invasion of tongue cancer: a prospective cohort study. Oral Oncol. 2019;91:79–84.
Murakami R, Shiraishi S, Yoshida R, Sakata J, Yamana K, Hirosue A, et al. Reliability of MRI-derived depth of invasion of oral tongue cancer. Acad Radiol. 2019;26:e180–6.
Baba A, Hashimoto K, Kayama R, Yamauchi H, Ikeda K, Ojiri H. Radiological approach for the newly incorporated T staging factor, depth of invasion (DOI), of the oral tongue cancer in the 8th edition of American Joint Committee on Cancer (AJCC) staging manual: assessment of the necessity for elective neck dissection. Jpn J Radiol. 2020;38:821–32.
Acknowledgements
We would like to thank Editage (www.editage.com) for English language editing. This work was supported by JSPS KAKENHI Grant Number 18K07757.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by RM, FS, RY, JS, AH, KK, and KY. The first draft of the manuscript was written by AM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
All authors declare that they have no conflict of interest.
Human and animal rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
Informed consent
The institutional review board of our institute approved this retrospective study (RINRI Number 1427). Informed consent was waived due to the retrospective nature of this study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Minamitake, A., Murakami, R., Sakamoto, F. et al. Can MRI-derived depth of invasion predict nodal recurrence in oral tongue cancer?. Oral Radiol 37, 641–646 (2021). https://doi.org/10.1007/s11282-020-00505-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11282-020-00505-3